MEDICARE: MS. KEHLI AYN MCCASKILL P.A.

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	17733	CA

General Provider Information

NPI Number	:	1457430365
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. KEHLI AYN MCCASKILL P.A.

Provider Business Mailing Address
First Line	:	1522 SARATOGA DR.
Second Line	:
City	:	WOODLAND
State	:	CA
Zip	:	95695
Country	:	US
Telephone Number	:	530-406-1286
Fax Number	:

Provider Business Practice Location Address
First Line	:	1522 SARATOGA DR
Second Line	:
City	:	WOODLAND
State	:	CA
Zip	:	95695-5027
Country	:	US
Telephone Number	:	530-406-1286
Fax Number	:

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

Provider Enumeration Date	:	11/02/2006
Last Update Date	:	07/08/2007

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