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NPI Code Detail

MEDICARE: ANTHONEY JAWAUN PAULISICH PA

MEDICARE: ANTHONEY JAWAUN PAULISICH PA
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 Assistant63692CA

General Provider Information

NPI Number : 1821638420
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANTHONEY JAWAUN PAULISICH PA
Provider Business Mailing Address
First Line : 3425 N 1ST ST
Second Line :
City : FRESNO
State : CA
Zip : 93726-6821
Country : US
Telephone Number : 559-608-6581
Fax Number :
Provider Business Practice Location Address
First Line : 3425 N 1ST ST
Second Line :
City : FRESNO
State : CA
Zip : 93726-6821
Country : US
Telephone Number : 559-608-6581
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/10/2020
Last Update Date : 12/18/2023

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Directions to “ ANTHONEY JAWAUN PAULISICH PA” Practice Location

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