Provider Demographics
NPI:1447202817
Name:NAVA, JORGE ARTHUR (PA)
Entity Type:Individual
Prefix:
First Name:JORGE
Middle Name:ARTHUR
Last Name:NAVA
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:GEORGE
Other - Middle Name:ARTHUR
Other - Last Name:NAVA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PA
Mailing Address - Street 1:3941 J ST
Mailing Address - Street 2:SUITE 270
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95819-3628
Mailing Address - Country:US
Mailing Address - Phone:916-733-6850
Mailing Address - Fax:916-733-6824
Practice Address - Street 1:3941 J ST
Practice Address - Street 2:SUITE 270
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95819-3628
Practice Address - Country:US
Practice Address - Phone:916-733-6850
Practice Address - Fax:916-733-6824
Is Sole Proprietor?:No
Enumeration Date:2006-05-16
Last Update Date:2013-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA10004363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPA10004Medicaid
CA0PA100041Medicare ID - Type UnspecifiedPPIN