Individual provider · Type 1 NPI
Mary Kreshon, PA-C
Medical Physician Assistant · San Diego, CA
NPI number
1114349693
Active
Practice location
6195 Lusk Blvd Ste 250
San Diego, CA 92121-3715
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Physician Assistant | 363A00000X | 001004757 (NC) |
| Surgical Physician Assistant | 363AS0400X | 0010-04757 (NC) |
| Medical Physician Assistant Primary | 363AM0700X | 52673 (CA) |
Medical Physician Assistant: Definition to come...
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About NPI 1114349693
Mary Kreshon, PA-C's National Provider Identifier is 1114349693, issued on Jan 17, 2014. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in San Diego, CA. The record was last updated on Dec 19, 2022.