Individual
MRS. DONNA LEE MAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.-C
Contact information
Practice address
290 N WAYTE LN, FRESNO, CA 93701-2124
(559) 459-1550
(559) 459-1017
Mailing address
2625 E DIVISADERO ST, FRESNO, CA 93721-1431
(559) 443-2682
(559) 443-2681
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA15145
CA
363AM0700X
Medical Physician Assistant
Primary
PA 15145
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA15145
LISCENCE PHYSICIAN ASSIST
CA
Enumeration date
12/13/2005
Last updated
06/18/2014
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