Lea Marie Pace, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA21171 Issued in CA

Practice address

4452 Park Blvd Ste 306
San Diego, CA 92116-4049

Phone

(619) 206-4232

NPI assigned

Oct 1, 2009

Last updated

Nov 15, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Lea Marie Dunn Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Jul 1, 2025 through Jul 1, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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

• Prospera Internal Medicine & Aesthetics, Inc.

  • Health Service Clinic/Center
  • San Diego, CA
  • NPI 1992545230
  NPD Authorized official
• Somagen Healthcare Inc

  dba AFC Urgent Care San Diego

  • Urgent Care Clinic/Center
  • Santee, CA
  • NPI 1396058137
  NPD (past)

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

{
    "created_epoch": "1254355200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731628800000",
    "number": "1710211180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4452 PARK BLVD STE 306",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921164049",
            "telephone_number": "619-206-4232",
            "fax_number": "833-972-5097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4452 PARK BLVD STE 306",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921164049",
            "telephone_number": "619-206-4232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PACE",
        "first_name": "LEA",
        "middle_name": "MARIE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-01",
        "last_updated": "2024-11-15",
        "certification_date": "2024-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": "10001128A",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA21171",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LEA",
            "last_name": "DUNN",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Adam Rodger Pacal, M.D.
• Jasmine Joy Pacal
• Avonne Michelle Pace
• Denise Karin Pace, M.D.
• Jordan Leaires Pace, MD
• Rachelle Pace, DNP
• Salvatore John Pacella III, M.D., M.B.A.
• Jillian Pacer
• Rebeca Pacheco Corvera, MFT
• Rebecca Pacheco-Spitz

• Medical Physician Assistant in San Diego, CA
• Providers in San Diego, 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 Nov 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.