Provider Demographics
NPI:1124219134
Name:WEST, JOAN M (PA-C)
Entity Type:Individual
Prefix:
First Name:JOAN
Middle Name:M
Last Name:WEST
Suffix:
Gender:F
Credentials:PA-C
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Mailing Address - Street 1:2490 HOSPITAL DR STE 303
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN VIEW
Mailing Address - State:CA
Mailing Address - Zip Code:94040-4124
Mailing Address - Country:US
Mailing Address - Phone:650-988-7500
Mailing Address - Fax:650-988-7536
Practice Address - Street 1:2490 HOSPITAL DR STE 303
Practice Address - Street 2:
Practice Address - City:MOUNTAIN VIEW
Practice Address - State:CA
Practice Address - Zip Code:94040-4124
Practice Address - Country:US
Practice Address - Phone:650-988-7500
Practice Address - Fax:650-988-7536
Is Sole Proprietor?:No
Enumeration Date:2007-08-05
Last Update Date:2021-12-30
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Provider Licenses
StateLicense IDTaxonomies
CA14548363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAS55818Medicare UPIN