Octavio Frias Penaloza PA-C

NPI 1154332492 - Physician Assistant - 363A00000X

NPI Details
NPI 1154332492
Gender Male
Enumeration Date 08/11/2006
Last Updated 03/03/2016
Entity Type Individual
Active Over 10 years ago
Practice Location
783 QUINTANA RD
URGENT CARE OF MORRO BAY, SUITE 1
MORRO BAY CA, 93442-1966, US
Phone (805) 771-0108
Fax (805) 771-0111
Business Location
783 QUINTANA RD
URGENT CARE OF MORRO BAY, SUITE 1
MORRO BAY CA, 93442-1966, US
Phone (805) 771-0108
Fax (805) 756-5298
Toxanomy
Taxonomy Code 363A00000X
License State California
License Number PA12685
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According to our database, Octavio Frias Penaloza PA-C NPI is 1154332492, taxonomy code is 363A00000X and license number is PA12685, license state is located at California. Octavio Frias Penaloza PA-C physically located at 783 Quintana Rd, Morro Bay CA, 93442-1966. NPI Number Octavio Frias Penaloza PA-C has the Individual type.

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1154332492 NPI number is provided on an as is basis without warranty of any kind. 1154332492 is maintained by the National Plan & Provider Enumeration System. The contents of Octavio Frias Penaloza PA-C are for informational purposes only.