MEDICARE: ROWENA PANTIG-ASTORGA M.D.

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	207Q00000X	Family Medicine Physician	4301078188	MI

Other Identifiers

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

General Provider Information

NPI Number	:	1710989223
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROWENA PANTIG-ASTORGA M.D.

Provider Business Mailing Address
First Line	:	8220 WYMARK DRIVE
Second Line	:	SUITE 200
City	:	ELK GROVE
State	:	CA
Zip	:	95757-0000
Country	:	US
Telephone Number	:	916-667-0600
Fax Number	:	916-683-0232

Provider Business Practice Location Address
First Line	:	8220 WYMARK DRIVE
Second Line	:	SUITE 200
City	:	ELK GROVE
State	:	CA
Zip	:	95757-0000
Country	:	US
Telephone Number	:	916-667-0600
Fax Number	:	916-683-0232

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

Provider Enumeration Date	:	08/15/2005
Last Update Date	:	10/04/2012

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