MEDICARE: ANGELICA PAROCUA 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	363A00000X	Physician Assistant	PA61267	CA

General Provider Information

NPI Number	:	1669116968
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANGELICA PAROCUA PA

Provider Business Mailing Address
First Line	:	284 DUPONT ST STE 130
Second Line	:
City	:	CORONA
State	:	CA
Zip	:	92879-6029
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	284 DUPONT ST STE 130
Second Line	:
City	:	CORONA
State	:	CA
Zip	:	92879-6029
Country	:	US
Telephone Number	:	951-394-3330
Fax Number	:

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

Provider Enumeration Date	:	04/22/2022
Last Update Date	:	03/14/2023

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Directions to “ ANGELICA PAROCUA PA” Practice Location

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