Ginger Lane PAC

NPI 1073663985 - Physician Assistant - 363A00000X

NPI Details
NPI 1073663985
Gender Female
Enumeration Date 01/11/2007
Last Updated 07/08/2007
Entity Type Individual
Active Over 9 years ago
Practice Location
620 SHADOW LN
LAS VEGAS NV, 89106-4119, US
Phone (702) 388-4500
Fax
Business Location
3916 STATE ST
#300
SANTA BARBARA CA, 93105-5602, US
Phone (805) 563-3011
Fax
Toxanomy
Taxonomy Code 363A00000X
License State Nevada
License Number PA1016
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According to our database, Ginger Lane PAC NPI is 1073663985, taxonomy code is 363A00000X and license number is PA1016, license state is located at Nevada. Ginger Lane PAC physically located at 620 Shadow Ln, Las Vegas NV, 89106-4119. NPI Number Ginger Lane PAC has the Individual type.

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1073663985 NPI number is provided on an as is basis without warranty of any kind. 1073663985 is maintained by the National Plan & Provider Enumeration System. The contents of Ginger Lane PAC are for informational purposes only.