Healthcare Provider Details

I. General information

NPI: 1154458255
Provider Name (Legal Business Name): LILIA ESTHER LLAMAS RX TECH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/27/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1148 E 46TH ST
LOS ANGELES CA
90011-3727
US

IV. Provider business mailing address

1148 E 46TH ST
LOS ANGELES CA
90011-3727
US

V. Phone/Fax

Practice location:
  • Phone: 323-234-6583
  • Fax:
Mailing address:
  • Phone: 323-234-6583
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183700000X
TaxonomyPharmacy Technician
License Number17145
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: