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NPI Code Detail

MEDICARE: KARLA KRISTINE PADOVA P.A-C

MEDICARE: KARLA KRISTINE PADOVA 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 AssistantPA14781CA

General Provider Information

NPI Number : 1578674891
Entity Type Code : Individual
Provider Name (Legal Business Name) : KARLA KRISTINE PADOVA P.A-C
Provider Business Mailing Address
First Line : 5266 E APPIAN WAY
Second Line :
City : LONG BEACH
State : CA
Zip : 90803-1904
Country : US
Telephone Number : 562-987-1819
Fax Number :
Provider Business Practice Location Address
First Line : 5266 E APPIAN WAY
Second Line :
City : LONG BEACH
State : CA
Zip : 90803-1904
Country : US
Telephone Number : 562-987-1819
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/31/2006
Last Update Date : 07/08/2007

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