Individual
PATRICK C ASTOURIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS PA-C
Contact information
Practice address
5565 GROSSMONT CENTER DR, BUILDING 3 SUITE 256, LA MESA, CA 91942-3020
(619) 462-3131
(619) 462-1731
Mailing address
2946 HOLLY RD, ALPINE, CA 91901-1510
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
PA16654
CA
363AM0700X
Medical Physician Assistant
Primary
PA16654
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0104522
—
CA
Enumeration date
10/03/2006
Last updated
09/07/2019
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