Healthcare Provider Details

I. General information

NPI: 1356760292
Provider Name (Legal Business Name): SYLVANA MARCELA HIDALGO M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/08/2014
Last Update Date: 05/28/2025
Certification Date: 05/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1300 N VERMONT AVE STE 402
LOS ANGELES CA
90027-6086
US

IV. Provider business mailing address

1300 N VERMONT AVE STE 402
LOS ANGELES CA
90027-6086
US

V. Phone/Fax

Practice location:
  • Phone: 323-953-9926
  • Fax:
Mailing address:
  • Phone: 323-953-9926
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0202X
TaxonomyPediatric Cardiology Physician
License NumberA148800
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberA148800
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: