Provider Demographics
NPI:1952485534
Name:KOYLE, MONA M (PA-C)
Entity type:Individual
Prefix:MRS
First Name:MONA
Middle Name:M
Last Name:KOYLE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1460 HIDDEN CANYON RD
Mailing Address - Street 2:
Mailing Address - City:LA HABRA HEIGHTS
Mailing Address - State:CA
Mailing Address - Zip Code:90631-8703
Mailing Address - Country:US
Mailing Address - Phone:562-964-8696
Mailing Address - Fax:
Practice Address - Street 1:300 E YORBA LINDA BLVD STE B
Practice Address - Street 2:
Practice Address - City:PLACENTIA
Practice Address - State:CA
Practice Address - Zip Code:92870-2910
Practice Address - Country:US
Practice Address - Phone:714-524-6000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2025-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA14495363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant