Most Relevant Information
Provider Data
| NPI Number: | 1003457565 |
| Provider Name: | TATIANA MONIQUE HURTADO PHYSICIAN ASSISTANT |
| Entity Type: | Individual |
| Taxonomy Code: | 363A00000X |
| Specialty: | Physician Assistant |
| License Number: |
Most Important Dates
| Enumeration Date: | 10/04/2019 |
| Last Updated: | 10/04/2019 |
Provider Practice Location
2200 DEL PASO BLVD
SACRAMENTO
CA
958153102
Practice Location Phone/Fax
| Phone: | 9169247988 |
| Fax: |
Provider Mailing Location
246 CADILLAC DRIVE #110
SACRAMENTO
CA
95825
Provider Mailing Phone/Fax
| Phone: | 5598017062 |
| Fax: |