Provider Demographics
NPI:1750562906
Name:CADANG, JAIMER GALVEZ (PA-C)
Entity type:Individual
Prefix:MR
First Name:JAIMER
Middle Name:GALVEZ
Last Name:CADANG
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44640 WOLTNER CT
Mailing Address - Street 2:
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92592-5679
Mailing Address - Country:US
Mailing Address - Phone:858-500-2873
Mailing Address - Fax:
Practice Address - Street 1:43500 RIDGE PARK DR
Practice Address - Street 2:
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92590-3624
Practice Address - Country:US
Practice Address - Phone:951-308-2200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-15
Last Update Date:2024-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA58766363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant