Healthcare Provider Details

I. General information

NPI: 1336810522
Provider Name (Legal Business Name): OSCAR LLAMAS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/27/2021
Last Update Date: 09/27/2021
Certification Date: 09/27/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 S LAKE AVE STE 300
PASADENA CA
91101-3009
US

IV. Provider business mailing address

3650 PERCY ST 1/2
LOS ANGELES CA
90023
US

V. Phone/Fax

Practice location:
  • Phone: 162-643-2727
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: