Provider Demographics
NPI:1275541229
Name:ARELLANO, JAMES PATRICK (PA)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:PATRICK
Last Name:ARELLANO
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 MEDICAL PLAZA DR
Mailing Address - Street 2:SUITE NUMBER 255
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95661-3043
Mailing Address - Country:US
Mailing Address - Phone:916-773-8700
Mailing Address - Fax:916-773-8701
Practice Address - Street 1:2 MEDICAL PLAZA DR
Practice Address - Street 2:SUITE 255
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95661-3043
Practice Address - Country:US
Practice Address - Phone:916-773-8700
Practice Address - Fax:916-773-8701
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2022-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA18502363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical