MEDICARE: ARLEADA F ROBERTSON PA

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
1	363AM0700X	Medical Physician Assistant	PA-18251	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	12317747	OTHER	CA	CAQH PROVIDER NUMBER
2	PA18251	OTHER	CA	PHYSICIAN ASSISTANT COMMITTEE CERTIFICATE NUMBER

General Provider Information

NPI Number	:	1275595563
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ARLEADA F ROBERTSON PA

Provider Business Mailing Address
First Line	:	500 FIRST ST
Second Line	:
City	:	PASO ROBLES
State	:	CA
Zip	:	93446-3742
Country	:	US
Telephone Number	:	805-226-4222
Fax Number	:

Provider Business Practice Location Address
First Line	:	500 FIRST ST
Second Line	:
City	:	PASO ROBLES
State	:	CA
Zip	:	93446-3742
Country	:	US
Telephone Number	:	805-226-4222
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/04/2006
Last Update Date	:	05/29/2014

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Directions to “ ARLEADA F ROBERTSON PA” Practice Location

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