Healthcare Provider Details

I. General information

NPI: 1891949319
Provider Name (Legal Business Name): ERLINDA VELASCO M.D.INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/11/2008
Last Update Date: 11/11/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

711 N ALVARADO ST # 106
LOS ANGELES CA
90026-4016
US

IV. Provider business mailing address

711 N ALVARADO ST # 106
LOS ANGELES CA
90026-4016
US

V. Phone/Fax

Practice location:
  • Phone: 213-413-3324
  • Fax: 213-413-6017
Mailing address:
  • Phone: 213-413-3324
  • Fax: 213-413-6017

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA367870
License Number StateCA

VIII. Authorized Official

Name: DR. ERLINDA CATE VELASCO
Title or Position: PRESIDENT
Credential: M.D.
Phone: 213-413-3324