Provider Demographics
NPI:1477721702
Name:DEMOOR, PATRICIA ANNE (PA-C, MS)
Entity Type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:ANNE
Last Name:DEMOOR
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Gender:F
Credentials:PA-C, MS
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Mailing Address - Street 1:3855 HEALTH SCIENCES DRIVE #0987
Mailing Address - Street 2:
Mailing Address - City:LA JOLLA
Mailing Address - State:CA
Mailing Address - Zip Code:92093-0987
Mailing Address - Country:US
Mailing Address - Phone:858-822-6294
Mailing Address - Fax:858-822-6316
Practice Address - Street 1:3855 HEALTH SCIENCES DRIVE #0987
Practice Address - Street 2:
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92093-0987
Practice Address - Country:US
Practice Address - Phone:858-822-6294
Practice Address - Fax:858-822-6316
Is Sole Proprietor?:No
Enumeration Date:2008-02-20
Last Update Date:2008-02-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAPA17504363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical