Provider Demographics
NPI:1831295831
Name:WRIGHT, GEORGE H (PA)
Entity Type:Individual
Prefix:
First Name:GEORGE
Middle Name:H
Last Name:WRIGHT
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2342 PROFESSIONAL PKWY STE 310
Mailing Address - Street 2:
Mailing Address - City:SANTA MARIA
Mailing Address - State:CA
Mailing Address - Zip Code:93455-6819
Mailing Address - Country:US
Mailing Address - Phone:805-934-2488
Mailing Address - Fax:805-934-2480
Practice Address - Street 1:2342 PROFESSIONAL PKWY STE 310
Practice Address - Street 2:
Practice Address - City:SANTA MARIA
Practice Address - State:CA
Practice Address - Zip Code:93455-6819
Practice Address - Country:US
Practice Address - Phone:805-934-2488
Practice Address - Fax:805-934-2480
Is Sole Proprietor?:No
Enumeration Date:2006-09-16
Last Update Date:2015-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA11271363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA49148Medicare UPIN
CAWPA112771CMedicare PIN