Provider Demographics
NPI:1508037300
Name:PASCASIO, MARY GUILLERMINE PAYAWAL (MD)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:GUILLERMINE PAYAWAL
Last Name:PASCASIO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MARY
Other - Middle Name:PAYAWAL
Other - Last Name:PASCASIO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:5601 DE SOTO AVE
Mailing Address - Street 2:
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91367-6701
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:365 E HILLCREST DR
Practice Address - Street 2:
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91360-5820
Practice Address - Country:US
Practice Address - Phone:888-515-3500
Practice Address - Fax:888-515-3500
Is Sole Proprietor?:No
Enumeration Date:2008-03-19
Last Update Date:2021-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA113048207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine