MEDICARE: TANIA PAJOUHESH

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	363A00000X	Physician Assistant	PA62568	CA

General Provider Information

NPI Number	:	1861270134
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TANIA PAJOUHESH

Provider Business Mailing Address
First Line	:	6699 ALVARADO RD STE 2209
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92120-5240
Country	:	US
Telephone Number	:	858-299-0009
Fax Number	:

Provider Business Practice Location Address
First Line	:	6699 ALVARADO RD STE 2209
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92120-5240
Country	:	US
Telephone Number	:	858-299-0009
Fax Number	:

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

Provider Enumeration Date	:	09/18/2023
Last Update Date	:	09/18/2023

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Directions to “ TANIA PAJOUHESH ” Practice Location

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