Healthcare Provider Details

I. General information

NPI: 1861829251
Provider Name (Legal Business Name): ASHLEY ANN ISABELL PA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/01/2013
Last Update Date: 10/01/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3633 CAMINO DEL RIO S SUITE 300
SAN DIEGO CA
92108-4011
US

IV. Provider business mailing address

3633 CAMINO DEL RIO S SUITE 300
SAN DIEGO CA
92108-4011
US

V. Phone/Fax

Practice location:
  • Phone: 619-287-9730
  • Fax: 619-287-4516
Mailing address:
  • Phone: 619-287-9730
  • Fax: 619-287-4516

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: