| Trang Lee, | |
|
207 W Legion Rd, Brawley, CA 92227-7780 | |
| (760) 351-3333 | |
| Not Available |
| Full Name | Trang Lee |
|---|---|
| Gender | Female |
| Speciality | Physician Assistant |
| Location | 207 W Legion Rd, Brawley, California |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356863997 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | PA54898 (California) | Primary |
| 390200000X | Student In An Organized Health Care Education/training Program | (* (Not Available)) | Secondary |
| Entity Name | Southern California Permanente Medical Group |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1770515280 PECOS PAC ID: 6002729175 Enrollment ID: O20031110000678 |
| Entity Name | Cep America - California |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1548667843 PECOS PAC ID: 6103739131 Enrollment ID: O20040121000458 |
| Mailing Address | Practice Location Address |
|---|---|
| Trang Lee, 207 W Legion Rd, Brawley, CA 92227-7780 Ph: Not Available | Trang Lee, 207 W Legion Rd, Brawley, CA 92227-7780 Ph: (760) 351-3333 |
Dina A. Jackson, PA-C Physician Assistant Medicare: Medicare Enrolled Practice Location: 900 Main St, Brawley, CA 92227 Phone: 559-213-0297 |
Mr. Marshall Ray Debruler, P.A.-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 207 W Legion Rd, Brawley, CA 92227 Phone: 760-445-3050 |
Omayra Montalvo, PA Physician Assistant Medicare: Medicare Enrolled Practice Location: 900 Main St, Brawley, CA 92227 Phone: 760-344-6471 Fax: 760-344-8410 |
Miss Autumn Leci Fornasero, M.S. PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 207 W Legion Rd, Brawley, CA 92227 Phone: 760-351-3333 |
Salma Foroozan, PA-C Physician Assistant Medicare: Medicare Enrolled Practice Location: 900 Main St, Brawley, CA 92227 Phone: 760-344-6471 Fax: 760-344-8410 |
Mr. Christopher Leslie Thompson, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 207 W Legion Rd, Brawley, CA 92227 Phone: 760-351-3333 |
Mark Simpson, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 207 W Legion Rd, Brawley, CA 92227 Phone: 760-351-3333 |