Healthcare Provider Details
I. General information
NPI: 1568014124
Provider Name (Legal Business Name): PAULETTE ESPARZA-RAMIREZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/14/2019
Last Update Date: 07/15/2021
Certification Date: 07/15/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
13001 RAMONA BLVD STE A
IRWINDALE CA
91706-3752
US
IV. Provider business mailing address
815 COLORADO BLVD STE 300
LOS ANGELES CA
90041-1744
US
V. Phone/Fax
- Phone: 626-373-2900
- Fax:
- Phone: 323-543-2800
- Fax: 323-978-1263
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225400000X |
| Taxonomy | Rehabilitation Practitioner |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: