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NPI Code Detail

MEDICARE: CHRISTINA COUSINS P.A.-C

MEDICARE: CHRISTINA COUSINS 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
1363A00000XPhysician Assistant3306AZ

General Provider Information

NPI Number : 1922022813
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTINA COUSINS P.A.-C
Provider Business Mailing Address
First Line : 1 EMBARCADERO CTR STE 1900
Second Line :
City : SAN FRANCISCO
State : CA
Zip : 94111-3723
Country : US
Telephone Number : 415-658-6791
Fax Number : 480-654-5761
Provider Business Practice Location Address
First Line : 2201 E CAMELBACK RD STE 101A
Second Line :
City : PHOENIX
State : AZ
Zip : 85016-3495
Country : US
Telephone Number : 888-663-6331
Fax Number : 415-252-7176
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/26/2006
Last Update Date : 03/17/2025

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Directions to “ CHRISTINA COUSINS P.A.-C” Practice Location

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