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NPI Code Detail

MEDICARE: MS. PATRICIA A WALLRICH PA-C

MEDICARE: MS. PATRICIA A WALLRICH PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician AssistantPA15073CA

General Provider Information

NPI Number : 1134229149
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. PATRICIA A WALLRICH PA-C
Provider Business Mailing Address
First Line : PO BOX 255228
Second Line :
City : SACRAMENTO
State : CA
Zip : 95865-5228
Country : US
Telephone Number : 800-470-0071
Fax Number :
Provider Business Practice Location Address
First Line : 9394 BIG HORN BLVD
Second Line :
City : ELK GROVE
State : CA
Zip : 95758-7977
Country : US
Telephone Number : 916-691-8524
Fax Number : 916-691-8595
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/22/2006
Last Update Date : 09/11/2008

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Directions to “ MS. PATRICIA A WALLRICH PA-C” Practice Location

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