MEDICARE: PASQUALE V PICCHIONE MD

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	207X00000X	Orthopaedic Surgery Physician	C30135	CA

General Provider Information

NPI Number	:	1740314897
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PASQUALE V PICCHIONE MD

Provider Business Mailing Address
First Line	:	968 N AVENIDA OLIVOS
Second Line	:
City	:	PALM SPRINGS
State	:	CA
Zip	:	92262-5744
Country	:	US
Telephone Number	:	760-325-9455
Fax Number	:	760-775-4818

Provider Business Practice Location Address
First Line	:	968 N AVENIDA OLIVOS
Second Line	:
City	:	PALM SPRINGS
State	:	CA
Zip	:	92262-5744
Country	:	US
Telephone Number	:	760-323-9455
Fax Number	:	760-775-4818

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

Provider Enumeration Date	:	03/14/2007
Last Update Date	:	07/08/2007

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