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NPI Code Detail

MEDICARE: MR. PATRICK RAYMOND DECOMMER P.A.-C

MEDICARE: MR. PATRICK RAYMOND DECOMMER 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 AssistantPA12317CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1PA12317OTHERCALICENSE

General Provider Information

NPI Number : 1285746057
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. PATRICK RAYMOND DECOMMER P.A.-C
Provider Business Mailing Address
First Line : PO BOX 6013
Second Line :
City : AUBURN
State : CA
Zip : 95604-6013
Country : US
Telephone Number : 530-889-6300
Fax Number : 530-889-6303
Provider Business Practice Location Address
First Line : 3227 PROFESSIONAL DR
Second Line : SUITE A
City : AUBURN
State : CA
Zip : 95602-2414
Country : US
Telephone Number : 530-889-6300
Fax Number : 530-889-6303
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/31/2006
Last Update Date : 03/07/2023

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