MEDICARE: ERIN TERAMOTO 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	PA62153	CA

General Provider Information

NPI Number	:	1669188843
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERIN TERAMOTO PA-C

Provider Business Mailing Address
First Line	:	3791 KATELLA AVE STE 201
Second Line	:
City	:	LOS ALAMITOS
State	:	CA
Zip	:	90720-2016
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3791 KATELLA AVE STE 201
Second Line	:
City	:	LOS ALAMITOS
State	:	CA
Zip	:	90720-2016
Country	:	US
Telephone Number	:	562-596-6736
Fax Number	:

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

Provider Enumeration Date	:	01/30/2023
Last Update Date	:	01/30/2023

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Directions to “ ERIN TERAMOTO PA-C” Practice Location

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