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NPI Code Detail

MEDICARE: LE'ANNA STJOHN PAUL PA-C

MEDICARE: LE'ANNA STJOHN PAUL 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
1363A00000XPhysician AssistantPA17603CA
2363A00000XPhysician AssistantAMD-889HI

General Provider Information

NPI Number : 1740358605
Entity Type Code : Individual
Provider Name (Legal Business Name) : LE'ANNA STJOHN PAUL PA-C
Provider Business Mailing Address
First Line : 2029 SIMPSON ST
Second Line :
City : HONOLULU
State : HI
Zip : 96819-2101
Country : US
Telephone Number : 707-756-0392
Fax Number :
Provider Business Practice Location Address
First Line : 1143 MISSOURI ST
Second Line :
City : FAIRFIELD
State : CA
Zip : 94533-6007
Country : US
Telephone Number : 707-756-0392
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/30/2006
Last Update Date : 02/06/2019

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Directions to “ LE'ANNA STJOHN PAUL PA-C” Practice Location

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