Basic Information
| Provider Information | |||||||||
| NPI: | 1659803906 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PASILIAO | ||||||||
| FirstName: | JERIMARIE | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 1628 | ||||||||
| Address2: | |||||||||
| City: | ORANGE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 928560628 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7146195383 | ||||||||
| FaxNumber: | 7707016801 | ||||||||
| Practice Location | |||||||||
| Address1: | 400 N TUSTIN AVE STE 400 | ||||||||
| Address2: | |||||||||
| City: | SANTA ANA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 927053850 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7146195383 | ||||||||
| FaxNumber: | 7146195396 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/28/2017 | ||||||||
| LastUpdateDate: | 06/03/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/03/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | A171258 | CA | Y | Allopathic & Osteopathic Physicians | Anesthesiology |
No ID Information.