Provider Demographics
NPI:1932273968
Name:MEJIA-NOVOA, MARIA ANGELES (PA-C)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:ANGELES
Last Name:MEJIA-NOVOA
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:MARIA
Other - Middle Name:ANGELES
Other - Last Name:MEJIA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHYSICIAN ASSISTANT
Mailing Address - Street 1:7400 MULLER ST
Mailing Address - Street 2:
Mailing Address - City:DOWNEY
Mailing Address - State:CA
Mailing Address - Zip Code:90241-2136
Mailing Address - Country:US
Mailing Address - Phone:562-897-1956
Mailing Address - Fax:562-291-2246
Practice Address - Street 1:5425 POMONA BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90022-1716
Practice Address - Country:US
Practice Address - Phone:323-728-0411
Practice Address - Fax:323-869-5362
Is Sole Proprietor?:No
Enumeration Date:2006-11-20
Last Update Date:2011-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA13586363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical