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NPI Code Detail

MEDICARE: ARIELE ANUVA ANDALON PA-C

MEDICARE: ARIELE ANUVA ANDALON PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant64936CA

General Provider Information

NPI Number : 1043030067
Entity Type Code : Individual
Provider Name (Legal Business Name) : ARIELE ANUVA ANDALON PA-C
Provider Business Mailing Address
First Line : 1906 BRUSH OAK CT
Second Line :
City : NEWBURY PARK
State : CA
Zip : 91320-5992
Country : US
Telephone Number : 805-559-1599
Fax Number :
Provider Business Practice Location Address
First Line : 1700 N ROSE AVE STE 320
Second Line :
City : OXNARD
State : CA
Zip : 93030-7648
Country : US
Telephone Number : 805-485-8709
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/14/2024
Last Update Date : 10/14/2024

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Directions to “ ARIELE ANUVA ANDALON PA-C” Practice Location

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