Provider Demographics
NPI:1982102604
Name:ISHAQ-JUAREZ, ANITA G (PA-C)
Entity Type:Individual
Prefix:
First Name:ANITA
Middle Name:G
Last Name:ISHAQ-JUAREZ
Suffix:
Gender:F
Credentials:PA-C
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Mailing Address - Street 1:91-1398 HALILI ST
Mailing Address - Street 2:
Mailing Address - City:EWA BEACH
Mailing Address - State:HI
Mailing Address - Zip Code:96706-6538
Mailing Address - Country:US
Mailing Address - Phone:281-409-8017
Mailing Address - Fax:
Practice Address - Street 1:99-128 AIEA HEIGHTS DR STE 703
Practice Address - Street 2:
Practice Address - City:AIEA
Practice Address - State:HI
Practice Address - Zip Code:96701-3978
Practice Address - Country:US
Practice Address - Phone:808-487-7938
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-29
Last Update Date:2018-11-09
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant