Healthcare Provider Details

I. General information

NPI: 1437303013
Provider Name (Legal Business Name): ASHLEY B DELUCA PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ASHLEY B MCCOMBER PA-C

II. Dates (important events)

Enumeration Date: 11/10/2008
Last Update Date: 10/31/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1501 WEST 24TH ST. SUITE C
YUMA AZ
85364
US

IV. Provider business mailing address

1501 WEST 24TH ST SUITE C
YUMA AZ
85364
US

V. Phone/Fax

Practice location:
  • Phone: 928-726-6335
  • Fax: 928-726-6338
Mailing address:
  • Phone: 928-726-6335
  • Fax: 928-726-6338

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: