NPI 1013587666

Kelly Denise Medina, PAC

Practitioner Physician Assistant Moreno Valley, CA

Practice location

Address: 26520 Cactus Ave, Moreno Valley, CA 92555-3927
Phone: (951) 486-4000
Mailing address: 333 Murfreesboro Pike, Nashville, TN 37210-2834

Registered specialties (2)

Physician Assistant Primary

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363A00000X Licence 61659 (CA)

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Student in an Organized Health Care Education/Training Program

Student, Health Care Taxonomy 390200000X

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Registry record

NPI: 1013587666
Entity type: Individual
Sex (as registered): Female
NPI issued: 27 Jun 2021
Record last updated: 27 Feb 2025

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.