Mabasa, Virginia

Mabasa, Virginia is an individual health care provider with primary practice located at 1017 S Fair Oaks Ave , Pasadena CA 91105-2621. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as her primary health care specialty. Mabasa, Virginia can be contacted via phone (626) 403-6200.

Contact Information

Primary practice address
1017 S Fair Oaks Ave Pasadena CA 91105-2621
Phone: (626) 403-6200
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X PA16259 California

Profile Details

NPI number 1922082924
LBN Legal business name Mabasa, Virginia
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 2nd, 2005
Last updated Apr 9th, 2012 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1922082924 NPPES
California Other PA16259 LICENSE

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