MEDICARE: MRS. DONNA ROXANNE MURESAN 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	363AM0700X	Medical Physician Assistant	PA19501	CA

General Provider Information

NPI Number	:	1912134495
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. DONNA ROXANNE MURESAN P.A.-C

Provider Business Mailing Address
First Line	:	23521 PASEO DE VALENCIA STE 204
Second Line	:
City	:	LAGUNA HILLS
State	:	CA
Zip	:	92653-3101
Country	:	US
Telephone Number	:	949-458-2026
Fax Number	:	949-273-8053

Provider Business Practice Location Address
First Line	:	23521 PASEO DE VALENCIA STE 204
Second Line	:
City	:	LAGUNA HILLS
State	:	CA
Zip	:	92653-3101
Country	:	US
Telephone Number	:	949-458-2026
Fax Number	:	949-273-8053

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

Provider Enumeration Date	:	06/11/2009
Last Update Date	:	08/24/2010

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