Healthcare Provider Details
I. General information
NPI: 1255185682
Provider Name (Legal Business Name): PAYTON JEAN ARGUE RRT
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 04/12/2024
Last Update Date: 04/12/2024
Certification Date: 04/08/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8380 CENTER DR STE E
LA MESA CA
91942-2952
US
IV. Provider business mailing address
8380 CENTER DR STE E
LA MESA CA
91942-2952
US
V. Phone/Fax
- Phone: 619-466-6077
- Fax: 619-466-6118
- Phone: 619-466-6077
- Fax: 619-466-6118
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 227900000X |
| Taxonomy | Registered Respiratory Therapist |
| License Number | 47212 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: