Provider Demographics
NPI:1467883504
Name:HAYES, PEDRO LYNN (NP)
Entity Type:Individual
Prefix:MR
First Name:PEDRO
Middle Name:LYNN
Last Name:HAYES
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41715 WINCHESTER RD
Mailing Address - Street 2:STE 101
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92590-4853
Mailing Address - Country:US
Mailing Address - Phone:909-880-6400
Mailing Address - Fax:
Practice Address - Street 1:1800 MEDICAL CENTER DR. #99
Practice Address - Street 2:
Practice Address - City:SAN BERNARDONO
Practice Address - State:CA
Practice Address - Zip Code:92411
Practice Address - Country:US
Practice Address - Phone:909-880-6400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-27
Last Update Date:2017-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA23709363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily