Healthcare Provider Details

I. General information

NPI: 1851720544
Provider Name (Legal Business Name): SANDRA PATRICIA LLAMAS B.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/04/2013
Last Update Date: 02/21/2020
Certification Date: 02/21/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3600 WILSHIRE BLVD STE 2200
LOS ANGELES CA
90010-2632
US

IV. Provider business mailing address

3600 WILSHIRE BLVD STE 2200
LOS ANGELES CA
90010-2632
US

V. Phone/Fax

Practice location:
  • Phone: 213-382-4400
  • Fax: 213-382-4494
Mailing address:
  • Phone: 213-382-4400
  • Fax: 213-382-4494

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: