Healthcare Provider Details

I. General information

NPI: 1588581771
Provider Name (Legal Business Name): CLAUDIA REVOLORIO LEMUS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/30/2026
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

249 E POMONA BLVD
MONTEREY PARK CA
91755-7237
US

IV. Provider business mailing address

2040 CAMFIELD AVE
COMMERCE CA
90040-1502
US

V. Phone/Fax

Practice location:
  • Phone: 888-499-9303
  • Fax:
Mailing address:
  • Phone: 888-499-9303
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: