Individual
AMBER LYNN PACHON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
4300 ROSE DR, YORBA LINDA, CA 92886
(714) 528-4211
Mailing address
4300 ROSE DR, YORBA LINDA, CA 92886-2026
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
036134569
IL
207Q00000X
Family Medicine Physician
Primary
A101464
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036134569
—
IL
01
—
592050
MEDICARE PTAN (CORNERSTONE GROUP)
IL
01
—
F400180484
MEDICARE PTAN (INDIVIDUAL)
IL
Enumeration date
12/23/2008
Last updated
11/09/2021
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