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NPI Code Detail

MEDICARE: AMELIA WHITNEY ELDRIDGE PA-C

MEDICARE:   AMELIA WHITNEY ELDRIDGE  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 Assistant67800CA

General Provider Information

NPI Number : 1295342905
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMELIA WHITNEY ELDRIDGE PA-C
Provider Business Mailing Address
First Line : 27 KNIGHT DR
Second Line :
City : SAN RAFAEL
State : CA
Zip : 94901-2530
Country : US
Telephone Number : 510-229-9881
Fax Number :
Provider Business Practice Location Address
First Line : 27 KNIGHT DR
Second Line :
City : SAN RAFAEL
State : CA
Zip : 94901-2530
Country : US
Telephone Number : 510-229-9881
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/26/2020
Last Update Date : 02/17/2026

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Directions to “ AMELIA WHITNEY ELDRIDGE PA-C” Practice Location

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