Provider Demographics
NPI:1114984192
Name:ASTORGA, YESENIA (PA-C)
Entity Type:Individual
Prefix:
First Name:YESENIA
Middle Name:
Last Name:ASTORGA
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2617 E 129TH ST
Mailing Address - Street 2:
Mailing Address - City:COMPTON
Mailing Address - State:CA
Mailing Address - Zip Code:90222-2211
Mailing Address - Country:US
Mailing Address - Phone:310-635-6738
Mailing Address - Fax:
Practice Address - Street 1:35000 GUADALCANAL AVE
Practice Address - Street 2:BMC MCRD
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92140-5599
Practice Address - Country:US
Practice Address - Phone:619-524-4045
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant