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Organization
WATSONVILLE MEDICAL CLINIC AND AESTHETIC CLINIC, INC
Active
Organization
WATSONVILLE MEDICAL CLINIC AND AESTHETIC CLINIC, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HUGO GERARDO MAR PA (PHYSICIAN ASSISTANT)
(831) 722-8787
Entity
Organization
Contact information
Practice address
284 PENNSYLVANIA DR, SUITE 1, WATSONVILLE, CA 95076-3768
(831) 722-8787
(831) 722-8881
Mailing address
284 PENNSYLVANIA DR, SUITE 1, WATSONVILLE, CA 95076-3768
(831) 722-8787
(831) 722-8881
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
A80671
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA13256
PHYSICIAN ASSISTANT NUMBER
CA
Enumeration date
06/07/2010
Last updated
06/07/2010
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