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NPI Code Detail

MEDICARE: EMILY CHRISTINE RALL PA-C

MEDICARE: EMILY CHRISTINE RALL 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
1363AM0700XMedical Physician AssistantPA883KY
2363A00000XPhysician AssistantPA01260OR

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2PA616POTHERKYCHOICE CARE
3000000357397OTHERKYANTHEM

General Provider Information

NPI Number : 1407855828
Entity Type Code : Individual
Provider Name (Legal Business Name) : EMILY CHRISTINE RALL PA-C
Provider Business Mailing Address
First Line : 3177 OCEAN VIEW BLVD
Second Line :
City : SAN DIEGO
State : CA
Zip : 92113-1432
Country : US
Telephone Number : 619-662-4100
Fax Number :
Provider Business Practice Location Address
First Line : 3177 OCEAN VIEW BLVD
Second Line :
City : SAN DIEGO
State : CA
Zip : 92113-1432
Country : US
Telephone Number : 619-662-4100
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/18/2005
Last Update Date : 07/12/2016

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Directions to “ EMILY CHRISTINE RALL PA-C” Practice Location

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