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Derrick Nicholas Damaso
Medical Physician Assistant in La Mesa, California
NPI 1598487035

Derrick Nicholas Damaso is a Medical Physician Assistant based in Castaic, CA and is specialized in Medical. Derrick Nicholas Damaso practices in La Mesa, CA. The NPI Number for Derrick Nicholas Damaso is 1598487035 and holds a License No. (California).

The current practice location address for Derrick Nicholas Damaso is 6136 Lake Murray Blvd, La Mesa, CA and can be reached out via phone at 877-693-6266.

Location: 6136 Lake Murray Blvd, La Mesa, CA, 91384-3729
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1598487035
Provider Name
Derrick Nicholas Damaso
Credential
Provider Entity Type
Individual
Gender
Male
Address
6136 Lake Murray Blvd, La Mesa, CA, 91384-3729
Phone Number
877-693-6266
Fax Number
Provider Enumeration Date
09/12/2022
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
6136 Lake Murray Blvd
City
La Mesa
State
California
Zip
91942-2502
Phone Number
877-693-6266
Fax Number
person
Provider Business Mailing Address Details
Address
6136 Lake Murray Blvd
City
La Mesa
State
California
Zip
91942-2502
Phone Number
877-693-6266
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Medical
Taxonomy
363AM0700X
License No.
PA62170 (California)
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
()
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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