Healthcare Provider Details

I. General information

NPI: 1417248337
Provider Name (Legal Business Name): PAULA ADRIANA ARRIAGA PA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/26/2011
Last Update Date: 04/26/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2645 OCEAN AVE #303
SAN FRANCISCO CA
94132-1633
US

IV. Provider business mailing address

583 LISBON ST
SAN FRANCISCO CA
94112-3562
US

V. Phone/Fax

Practice location:
  • Phone: 415-452-1200
  • Fax:
Mailing address:
  • Phone: 510-304-4339
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA21563
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: