Healthcare Provider Details

I. General information

NPI: 1992761449
Provider Name (Legal Business Name): MICHAEL R. DARIUS PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/25/2006
Last Update Date: 01/30/2024
Certification Date: 01/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

329 W. 8TH ST. SUITE 101
HANFORD CA
93230-4533
US

IV. Provider business mailing address

1600 CREEKSIDE DR STE 1400
FOLSOM CA
95630-3445
US

V. Phone/Fax

Practice location:
  • Phone: 559-587-4532
  • Fax: 559-589-1867
Mailing address:
  • Phone: 916-984-8244
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberPA 15354
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA15354
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA 15354
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: