Pavliscak, Jill Kathleen
Pavliscak, Jill Kathleen is an individual health care provider with primary practice located at 575 Kelly St , Half Moon Bay CA 94019-1719. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Pavliscak, Jill Kathleen can be contacted via phone (650) 560-0216.Contact Information
Primary practice address
575 Kelly St
Half Moon Bay CA 94019-1719
Phone: (650) 560-0216
Fax: (560) 295-0397
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | A104908 | California |
Profile Details
| NPI number | 1144258765 |
|---|---|
| LBN Legal business name | Pavliscak, Jill Kathleen |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 30th, 2006 |
| Last updated | Jun 13th, 2012 - about 13 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1144258765 | NPPES |
| New Mexico | MEDICAID | 3459501 |
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