Healthcare Provider Details

I. General information

NPI: 1174441430
Provider Name (Legal Business Name): DYLAN JOHN PINATELLI PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2026
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2519 E WHITMORE AVE
CERES CA
95307-2634
US

IV. Provider business mailing address

2519 E WHITMORE AVE
CERES CA
95307-2634
US

V. Phone/Fax

Practice location:
  • Phone: 209-537-4700
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA68640
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: