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NPI Code Detail

MEDICARE: DENICHE FRANCIS PA-C

MEDICARE: DENICHE FRANCIS 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 Assistant18997CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1205044104
Entity Type Code : Individual
Provider Name (Legal Business Name) : DENICHE FRANCIS PA-C
Provider Business Mailing Address
First Line : 111 N SEPULVEDA BLVD STE 210
Second Line :
City : MANHATTAN BEACH
State : CA
Zip : 90266-6849
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 111 N SEPULVEDA BLVD STE 210
Second Line :
City : MANHATTAN BEACH
State : CA
Zip : 90266-6849
Country : US
Telephone Number : 310-379-2134
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/21/2007
Last Update Date : 03/09/2017

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Directions to “ DENICHE FRANCIS PA-C” Practice Location

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