MEDICARE: AARON MARCEL SANDERS 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	363AS0400X	Surgical Physician Assistant	PA18321	CA

General Provider Information

NPI Number	:	1659325595
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AARON MARCEL SANDERS PA-C

Provider Business Mailing Address
First Line	:	5725 W LAS POSITAS BLVD
Second Line	:	SUITE 200
City	:	PLEASANTON
State	:	CA
Zip	:	94588-4054
Country	:	US
Telephone Number	:	925-469-6274
Fax Number	:	925-924-1769

Provider Business Practice Location Address
First Line	:	5725 W LAS POSITAS BLVD
Second Line	:	SUITE 200
City	:	PLEASANTON
State	:	CA
Zip	:	94588-4054
Country	:	US
Telephone Number	:	925-469-6274
Fax Number	:	925-924-1769

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

Provider Enumeration Date	:	05/22/2006
Last Update Date	:	01/03/2022

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