MEDICARE: MR. CRAIG A. RHOADES PA

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
1	363AM0700X	Medical Physician Assistant	363AM0700X	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	19345	OTHER	CA	PA-C

General Provider Information

NPI Number	:	1164612990
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. CRAIG A. RHOADES PA

Provider Business Mailing Address
First Line	:	1531 PLUMAS CT
Second Line	:	SUITE B
City	:	YUBA CITY
State	:	CA
Zip	:	95991-2966
Country	:	US
Telephone Number	:	530-751-4900
Fax Number	:	530-751-4901

Provider Business Practice Location Address
First Line	:	1908 N BEALE RD STE E
Second Line	:
City	:	MARYSVILLE
State	:	CA
Zip	:	95901-6937
Country	:	US
Telephone Number	:	530-743-6888
Fax Number	:	530-743-9823

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/27/2007
Last Update Date	:	03/07/2023

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