Provider Demographics
NPI:1417097973
Name:USN
Entity Type:Organization
Organization Name:USN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN ASSISTANT - CERTIFIED
Authorized Official - Prefix:MS
Authorized Official - First Name:JOELLE
Authorized Official - Middle Name:L
Authorized Official - Last Name:ANNANDONO
Authorized Official - Suffix:
Authorized Official - Credentials:PA-C
Authorized Official - Phone:619-532-6666
Mailing Address - Street 1:34800 BOB WILSON DR
Mailing Address - Street 2:NMCSD
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92134-1098
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:34800 BOB WILSON DR
Practice Address - Street 2:NMCSD
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92134-1098
Practice Address - Country:US
Practice Address - Phone:619-532-6666
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedicalGroup - Single Specialty