Healthcare Provider Details

I. General information

NPI: 1821222811
Provider Name (Legal Business Name): ISMAEL FRANCISCO LLC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/06/2009
Last Update Date: 04/10/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

531 E 36TH ST SUITE 1
LOS ANGELES CA
90011
US

IV. Provider business mailing address

6111 MILLUX AVE
PICO RIVERA CA
90660-3342
US

V. Phone/Fax

Practice location:
  • Phone: 562-222-4855
  • Fax: 323-370-6759
Mailing address:
  • Phone: 562-222-4855
  • Fax: 323-370-6759

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172A00000X
TaxonomyDriver
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: