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General NPI Number Information
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NPI Number | 1649164658
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Entity Type | Individual
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Provider Name | MACKENZIE PAIGE SAETEURN
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Gender | Female
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Dates
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Enumeration Date | 06/04/2025
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Last Update Date | 06/04/2025
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Provider Practice Location Address
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Address Line | 100 W CALIFORNIA BLVD
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City | PASADENA
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State | CA
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Zip | 91105-3010
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Country | US
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Telephone | 626-397-5000
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Fax |
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Provider Business Mailing Address
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Address Line | 1408 W 14TH ST
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City | UPLAND
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State | CA
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Zip | 91786-2521
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WG0000X
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Taxonomy Name | General Practice Registered Nurse
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License Number | 95166149
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License Number State | CA
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