Mary F Eanes, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA 12590 Issued in CA

Practice address

9700 El Camino Real
Suite 100
Atascadero, CA 93422-5569

Phone

(805) 461-9000

Fax

(805) 461-9001

NPI assigned

Nov 8, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Central Coast Health Care, Inc.

  • Urgent Care Clinic/Center
  • Atascadero, CA
  • NPI 1689938086
  NPD (past)
• Central Coast Healthcare, a Professional Medical Corp

  • Urgent Care Clinic/Center
  • Atascadero, CA
  • NPI 1073739025
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1209081600000",
    "number": "1336219252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9700 EL CAMOINO REAL",
            "address_2": "SUITE 100",
            "city": "ATASCADERO",
            "state": "CA",
            "postal_code": "934225571",
            "telephone_number": "805-461-9000",
            "fax_number": "805-461-9001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9700 EL CAMINO REAL",
            "address_2": "SUITE 100",
            "city": "ATASCADERO",
            "state": "CA",
            "postal_code": "934225569",
            "telephone_number": "805-461-9000",
            "fax_number": "805-461-9001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EANES",
        "first_name": "MARY",
        "middle_name": "F",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-08",
        "last_updated": "2008-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA 12590",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE #",
            "identifier": "PA 12590",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jamie Noelle Dunn, LMFT
• Rachel Laetitia Duros, PHD
• Mark Durrant, RPH
• Dwayne R Burbach DDS Inc
• Katleho Ivan Dyoyi, MS
• Maria Antonieta Soria Echard, NP
• Tayler Nicole Edwards
• Molly Anne Eisen-Kearns, LCSW
• El Camino Homeless Organization
• Cindy Kang Elliott, M.D.

• Medical Physician Assistant in Atascadero, CA
• Providers in Atascadero, CA by specialty
• Medical Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.