Healthcare Provider Details

I. General information

NPI: 1619716131
Provider Name (Legal Business Name): YVETTE MARLENE ROJAS PHLEBOTOMIST
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/23/2024
Last Update Date: 05/23/2024
Certification Date: 05/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5970 S CENTRAL AVE
LOS ANGELES CA
90001-1150
US

IV. Provider business mailing address

5970 S CENTRAL AVE
LOS ANGELES CA
90001-1150
US

V. Phone/Fax

Practice location:
  • Phone: 323-234-3280
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246RP1900X
TaxonomyPhlebotomy Technician
License NumberCPT-02389011
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: