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NPI Code Detail

MEDICARE: CELINE THERESA PELE P.A.

MEDICARE: CELINE THERESA PELE 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
1363A00000XPhysician AssistantPA15144CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1699716548
Entity Type Code : Individual
Provider Name (Legal Business Name) : CELINE THERESA PELE P.A.
Provider Business Mailing Address
First Line : 2424 BOLIER AVE
Second Line :
City : MCKINLEYVILLE
State : CA
Zip : 95519-3307
Country : US
Telephone Number : 707-839-5626
Fax Number : 707-822-0138
Provider Business Practice Location Address
First Line : 3800 JANES RD
Second Line :
City : ARCATA
State : CA
Zip : 95521-4742
Country : US
Telephone Number : 707-826-8264
Fax Number : 707-826-8292
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/10/2006
Last Update Date : 03/28/2012

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Directions to “ CELINE THERESA PELE P.A.” Practice Location

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