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NPI Code Detail

MEDICARE: MS. M. BARBARA KLYDE PAC

MEDICARE: MS. M. BARBARA KLYDE PAC
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
1363AM0700XMedical Physician AssistantPA 10707CA

General Provider Information

NPI Number : 1740309608
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. M. BARBARA KLYDE PAC
Provider Business Mailing Address
First Line : 2391 N RIVER TRAIL RD
Second Line :
City : ORANGE
State : CA
Zip : 92865-2036
Country : US
Telephone Number : 171-492-1896
Fax Number : 171-463-7426
Provider Business Practice Location Address
First Line : 1711 W KATELLA AVE
Second Line :
City : ANAHEIM
State : CA
Zip : 92804-6450
Country : US
Telephone Number : 714-400-2959
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/29/2007
Last Update Date : 02/07/2025

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Directions to “ MS. M. BARBARA KLYDE PAC” Practice Location

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