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NPI Code Detail

MEDICARE: MRS. CATHERINE C THAXTER P.A.-C

MEDICARE: MRS. CATHERINE C THAXTER P.A.-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 AssistantPA18013CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10201103OTHERCASTATE OF WASHINGTON

General Provider Information

NPI Number : 1073502449
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. CATHERINE C THAXTER P.A.-C
Provider Business Mailing Address
First Line : 1250 W MORAGA RD
Second Line :
City : FRESNO
State : CA
Zip : 93711-0520
Country : US
Telephone Number : 559-432-4556
Fax Number :
Provider Business Practice Location Address
First Line : 2823 FRESNO ST
Second Line :
City : FRESNO
State : CA
Zip : 93721-1324
Country : US
Telephone Number : 559-459-6000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/19/2005
Last Update Date : 10/02/2015

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Directions to “ MRS. CATHERINE C THAXTER P.A.-C” Practice Location

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