MEDICARE: JULIE ANN TREUNER 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
1	363A00000X	Physician Assistant	17478	CA

General Provider Information

NPI Number	:	1922013614
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULIE ANN TREUNER PA

Provider Business Mailing Address
First Line	:	823 GATEWAY CENTER WAY
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92102
Country	:	US
Telephone Number	:	619-515-2300
Fax Number	:	619-906-4564

Provider Business Practice Location Address
First Line	:	4094 4TH AVE
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92103-2143
Country	:	US
Telephone Number	:	619-515-2143
Fax Number	:

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

Provider Enumeration Date	:	07/30/2006
Last Update Date	:	08/24/2023

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