MEDICARE: MRS. RACHEL ELIZABETH KROCHMAL F.N.P./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
1	363LF0000X	Family Nurse Practitioner	RN457272	CA
2	363A00000X	Physician Assistant	52203	CA

General Provider Information

NPI Number	:	1326117920
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. RACHEL ELIZABETH KROCHMAL F.N.P./PA-C

Provider Business Mailing Address
First Line	:	488 E VALLEY PKWY STE 311
Second Line	:
City	:	ESCONDIDO
State	:	CA
Zip	:	92025-3374
Country	:	US
Telephone Number	:	760-746-2860
Fax Number	:	760-738-9501

Provider Business Practice Location Address
First Line	:	488 E VALLEY PKWY STE 311
Second Line	:
City	:	ESCONDIDO
State	:	CA
Zip	:	92025-3374
Country	:	US
Telephone Number	:	760-746-2860
Fax Number	:	760-738-9501

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

Provider Enumeration Date	:	11/07/2006
Last Update Date	:	07/31/2015

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