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NPI Code Detail

MEDICARE: LILI'A CHRISTA FA'AOLA BA

MEDICARE: LILI'A CHRISTA FA'AOLA BA
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
1171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1376685594
Entity Type Code : Individual
Provider Name (Legal Business Name) : LILI'A CHRISTA FA'AOLA BA
Provider Business Mailing Address
First Line : 925 ALVIN ST
Second Line :
City : SAN DIEGO
State : CA
Zip : 92114-1823
Country : US
Telephone Number : 619-263-6845
Fax Number :
Provider Business Practice Location Address
First Line : 7155 MISSION GORGE RD
Second Line :
City : SAN DIEGO
State : CA
Zip : 92120-1130
Country : US
Telephone Number : 858-300-0460
Fax Number : 858-300-0461
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/13/2007
Last Update Date : 03/18/2011

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Directions to “ LILI'A CHRISTA FA'AOLA BA” Practice Location

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