Provider Demographics
NPI:1073827341
Name:PHYSICIAN ASSISTANT HOUSE CALLS INC
Entity Type:Organization
Organization Name:PHYSICIAN ASSISTANT HOUSE CALLS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:RICHARDSON
Authorized Official - Suffix:JR
Authorized Official - Credentials:PA
Authorized Official - Phone:866-714-1326
Mailing Address - Street 1:151 N KRAEMER BLVD
Mailing Address - Street 2:STE 100
Mailing Address - City:PLACENTIA
Mailing Address - State:CA
Mailing Address - Zip Code:92870-5002
Mailing Address - Country:US
Mailing Address - Phone:888-929-4198
Mailing Address - Fax:562-790-8114
Practice Address - Street 1:151 N KRAEMER BLVD
Practice Address - Street 2:STE 100
Practice Address - City:PLACENTIA
Practice Address - State:CA
Practice Address - Zip Code:92870-5002
Practice Address - Country:US
Practice Address - Phone:888-929-4198
Practice Address - Fax:562-790-8114
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-29
Last Update Date:2014-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA280173363AM0700X
CAPA19918207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedicalGroup - Multi-Specialty