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NPI Code Detail

MEDICARE: MISS LOTA N RELATO

MEDICARE: MISS LOTA N RELATO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1291U00000XClinical Medical LaboratoryCLF334485CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1CLF334485OTHERCALAB ID NUMBER

General Provider Information

NPI Number : 1114190279
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS LOTA N RELATO
Provider Business Mailing Address
First Line : 8071 SLATER AVE
Second Line : STE 100
City : HUNTINGTON BEACH
State : CA
Zip : 92647
Country : US
Telephone Number : 714-841-7789
Fax Number : 714-841-9966
Provider Business Practice Location Address
First Line : 8071 SLATER AVE
Second Line : STE 100
City : HUNTINGTON BEACH
State : CA
Zip : 92647
Country : US
Telephone Number : 714-841-7789
Fax Number : 714-841-9966
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/10/2008
Last Update Date : 04/10/2008

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Directions to “ MISS LOTA N RELATO ” Practice Location

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