ELYSSA SUMMER MCCORMACK (NPI# 1710593397) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710593397 |
| Entity Type | Individual |
| Full Name | ELYSSA SUMMER MCCORMACK |
| Credential | PA-C |
| Practice Address |
275 N Oakland Ave Apt 2 Pasadena CA 91101-1647 |
| Practice Telephone | 9517043526 |
| Mailing Telephone | 9517043526 |
| Enumeration Date | 2020-09-19 |
| Last Update Date | 2020-09-19 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PA58537 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
275 N OAKLAND AVE APT 2 |
| City | PASADENA |
| State | CA |
| Zip Code | 91101-1647 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720696404 | Sophia Ting-jan Liang | Student in an Organized Health Care Education/Training Program | 98 S. Los Robles Ave., Kaiser Permanente Bernard J. Tyson School of Medicine, Pasdena, CA 91101 | 2020-07-17 |
| 1851917033 | Casa De Las Amigas | Lodging | 173 N Oak Knoll Ave, Pasadena, CA 91101 | 2020-06-23 |
| 1467076869 | Tong Qi | Student in an Organized Health Care Education/Training Program | Kaiser Permanente Bernard Kj. Tyson School of Medicine, Pasadena, CA 91101 | 2020-06-01 |
| 1386267839 | Kelly B Shriver | Student in an Organized Health Care Education/Training Program | Kaiser Permanente Bernard J. Tyson School of Medicine, 98 S. Los Robles, Pasadena, CA 91101 | 2020-05-19 |
| 1427600758 | Brooke Danielle Pechman | Marriage & Family Therapist | 221 E Walnut Street, Suite 138, Pasadena, CA 91101 | 2019-07-16 |
| 1952897563 | Robert Howes Hambleton | Dentist | 200 S. Oak Knoll Ave #201, Pasadena, CA 91101 | 2018-07-06 |
| 1801306774 | Joseph Hendrix | Social Worker | 1500 South Mcdonnell Avenue, Commerce, CA 91101 | 2017-10-05 |
| 1730606070 | Candice Anne Watson | Nurse Practitioner | 350 South Madison Ave #322, Pasadena, CA 91101 | 2017-08-28 |
| 1700320223 | Jenny H. Pak | Psychologist | 180 N. Oakland Ave., Pasadena, CA 91101 | 2016-12-19 |
| 1578005401 | James Maddox | Student in an Organized Health Care Education/Training Program | 447 El Molino Ave, Pasadena, CA 91101 | 2016-11-09 |
| Find all providers in zip 91101 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356951941 | Emily Lynn Yang | Physician Assistant | 3219 Fairpoint St, Pasadena, CA 91107-1202 | 2020-08-07 |
| 1326675414 | Melissa Real | Physician Assistant | 845 Wright Ave, Pasadena, CA 91104-4466 | 2020-03-26 |
| 1164064762 | Nikita Phiroz Engineer | Physician Assistant | 4102 Woodlawn Ave Ste 210, Pasadena, TX 77504-1949 | 2019-10-15 |
| 1275189979 | Robert Hennington | Physician Assistant | 111 Red Bluff Rd, Pasadena, TX 77506-1530 | 2019-08-18 |
| 1306329586 | Sofia Fiona Knoppel-calas | Physician Assistant | 215 N Allen Ave, Pasadena, CA 91106-1601 | 2018-09-13 |
| 1598136517 | Cara Kylie Jugant | Physician Assistant | 3450 Fairpoint St, Pasadena, CA 91107-1207 | 2015-10-16 |
| 1962870451 | Christopher Fong | Physician Assistant | 455 W Montana St, Pasadena, CA 91103-1327 | 2015-09-14 |
| 1629451380 | Mary Evelyn Smith | Physician Assistant | 2080 San Pasqual St, Pasadena, CA 91107-5157 | 2015-06-30 |
| 1861899445 | Ryan Whitworth | Physician Assistant | 140 N Lake Ave, Pasadena, CA 91101-1836 | 2014-11-26 |
| 1124437439 | Monica Marshall | Physician Assistant | 908 Southmore Ave Ste 200, Pasadena, TX 77502-1125 | 2014-08-12 |
| Find all providers in PASADENA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.