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NPI Code Detail

MEDICARE: ASHLEY ERAZO PA-C

MEDICARE: ASHLEY ERAZO 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 Assistant

General Provider Information

NPI Number : 1588128177
Entity Type Code : Individual
Provider Name (Legal Business Name) : ASHLEY ERAZO PA-C
Provider Business Mailing Address
First Line : 5555 GROSSMONT CENTER DR
Second Line :
City : LA MESA
State : CA
Zip : 91942-3019
Country : US
Telephone Number : 619-740-6000
Fax Number :
Provider Business Practice Location Address
First Line : 5555 GROSSMONT CENTER DR
Second Line :
City : LA MESA
State : CA
Zip : 91942-3019
Country : US
Telephone Number : 619-740-6000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/28/2019
Last Update Date : 01/08/2026

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Directions to “ ASHLEY ERAZO PA-C” Practice Location

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