MEDICARE: MISS KARYN MARSEILLE ARBET 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	363A00000X	Physician Assistant	PA13172	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	PA 13172	OTHER	CA	PHYSICIAN ASSISTANT

General Provider Information

NPI Number	:	1417178526
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS KARYN MARSEILLE ARBET PA-C

Provider Business Mailing Address
First Line	:	1704 W MANCHESTER AVE STE 101
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90047-3056
Country	:	US
Telephone Number	:	323-778-6215
Fax Number	:	323-778-6312

Provider Business Practice Location Address
First Line	:	1704 W MANCHESTER AVE STE 101
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90047-3056
Country	:	US
Telephone Number	:	323-778-6215
Fax Number	:	323-778-6312

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

Provider Enumeration Date	:	05/02/2007
Last Update Date	:	07/08/2007

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