Pamela J Weakland, P.A.

Individual provider Active NPI Physician Assistant · California, PA

NPI 1881685386 · NPPES record last updated Aug 16, 2011

Key facts

NPI
1881685386
Entity type
Individual (NPI type 1)
Primary specialty
Physician Assistant 363A00000X
License
MA002067L (PA)
Practice address
1152 Wood St
California, PA 15419-1260
Phone
(724) 938-2122
NPI assigned
Nov 3, 2005
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
MA002067LPAMDPhysician Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X MA002067L PA Yes

Addresses

Primary practice location

1152 Wood St
California, PA 15419-1260

Mailing address

1070 Old National Pike
Fredericktown, PA 15333-2114
Phone (724) 632-6801

Other identifiers

IdentifierTypeStateIssuer
1007288440095MedicaidPA

Other providers in California, PA

All providers in California, PA · Physician Assistant in Pennsylvania

Sources for this page

Verify at the official NPI Registry.