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NPI Code Detail

MEDICARE: IVONNE VELADO PA-C

MEDICARE: IVONNE VELADO 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 AssistantPA16275CA

General Provider Information

NPI Number : 1154370963
Entity Type Code : Individual
Provider Name (Legal Business Name) : IVONNE VELADO PA-C
Provider Business Mailing Address
First Line : 1798 BAY RD STE A
Second Line :
City : EAST PALO ALTO
State : CA
Zip : 94303-5312
Country : US
Telephone Number : 650-321-0980
Fax Number : 650-321-0988
Provider Business Practice Location Address
First Line : 1798 BAY RD STE A
Second Line :
City : EAST PALO ALTO
State : CA
Zip : 94303-5312
Country : US
Telephone Number : 650-321-0980
Fax Number : 650-321-0988
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/09/2006
Last Update Date : 03/12/2012

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Directions to “ IVONNE VELADO PA-C” Practice Location

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