Individual
DR. KATHLEEN A PAVEGLIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4002 VISTA WAY, OCEANSIDE, CA 92056-4506
(760) 473-7969
Mailing address
PO BOX 3356, VISTA, CA 92085-3356
(760) 672-4995
(760) 867-2495
Taxonomy
Speciality
Code
Description
License number
State
207RI0011X
Interventional Cardiology Physician
Primary
G48106
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
060011073
RAILROAD MEDICARE
—
01
—
060012306
RAILROAD MEDICARE
—
05
—
GR0029770
—
CA
Enumeration date
07/26/2005
Last updated
10/15/2019
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