MEDICARE: DR. ASHLEY ADVINCULA MD

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	207P00000X	Emergency Medicine Physician	A192406	CA

General Provider Information

NPI Number	:	1427636497
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ASHLEY ADVINCULA MD

Provider Business Mailing Address
First Line	:	31951 DOVE CANYON DR
Second Line	:
City	:	TRABUCO CANYON
State	:	CA
Zip	:	92679-3749
Country	:	US
Telephone Number	:	949-557-0890
Fax Number	:

Provider Business Practice Location Address
First Line	:	31951 DOVE CANYON DR
Second Line	:
City	:	TRABUCO CANYON
State	:	CA
Zip	:	92679-3749
Country	:	US
Telephone Number	:	949-557-0890
Fax Number	:

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

Provider Enumeration Date	:	03/31/2021
Last Update Date	:	11/12/2024

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