Healthcare Provider Details

I. General information

NPI: 1033170600
Provider Name (Legal Business Name): MICHELLE PARTAIN PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2006
Last Update Date: 04/24/2026
Certification Date: 04/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3811 CARMEL VALLEY RD
SAN DIEGO CA
92130
US

IV. Provider business mailing address

10790 RANCHO BERNARDO RD
SAN DIEGO CA
92127-5705
US

V. Phone/Fax

Practice location:
  • Phone: 858-554-7439
  • Fax:
Mailing address:
  • Phone: 858-554-7439
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberPA15228
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: