Provider Demographics
NPI:1346869195
Name:MAQUET, ISAAC M (PA)
Entity Type:Individual
Prefix:
First Name:ISAAC
Middle Name:M
Last Name:MAQUET
Suffix:
Gender:M
Credentials:PA
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Mailing Address - Street 1:10790 RANCHO BERNARDO RD
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92127-5705
Mailing Address - Country:US
Mailing Address - Phone:858-554-7989
Mailing Address - Fax:858-554-6296
Practice Address - Street 1:10710 N TORREY PINES RD
Practice Address - Street 2:
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92037-1035
Practice Address - Country:US
Practice Address - Phone:858-554-7989
Practice Address - Fax:858-554-6296
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-12
Last Update Date:2021-04-20
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Provider Licenses
StateLicense IDTaxonomies
CAPA59389363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant