Healthcare Provider Details

I. General information

NPI: 1689402935
Provider Name (Legal Business Name): REGINE MARIE LAPITAN NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/26/2024
Last Update Date: 07/26/2024
Certification Date: 07/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 S COAST HWY
LAGUNA BEACH CA
92651-2968
US

IV. Provider business mailing address

1702 E ALBREDA ST
CARSON CA
90745-1818
US

V. Phone/Fax

Practice location:
  • Phone: 949-632-8087
  • Fax:
Mailing address:
  • Phone: 310-977-7142
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number95028416
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: