MEDICARE: MS. BARBARA ADELE SANTA CRUZ P.A-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
1	363A00000X	Physician Assistant	PA11161	CA

General Provider Information

NPI Number	:	1881775088
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. BARBARA ADELE SANTA CRUZ P.A-C

Provider Business Mailing Address
First Line	:	8231 ROCHESTER AVE
Second Line	:	STE 110
City	:	RANCHO CUCAMONGA
State	:	CA
Zip	:	91730-0735
Country	:	US
Telephone Number	:	909-463-9952
Fax Number	:

Provider Business Practice Location Address
First Line	:	7777 MILLIKEN AVE
Second Line	:	SUITE 240
City	:	RANCHO CUCAMONGA
State	:	CA
Zip	:	91730-6780
Country	:	US
Telephone Number	:	909-941-0247
Fax Number	:	909-948-7950

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

Provider Enumeration Date	:	10/17/2006
Last Update Date	:	03/06/2020

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