Healthcare Provider Details

I. General information

NPI: 1477885192
Provider Name (Legal Business Name): YVONNA RADPARVAR PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/04/2010
Last Update Date: 04/20/2026
Certification Date: 04/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

280 N WESTLAKE BLVD STE 210
WESTLAKE VILLAGE CA
91362-7021
US

IV. Provider business mailing address

2901 W COAST HWY SUITE #150
NEWPORT BEACH CA
92663-4023
US

V. Phone/Fax

Practice location:
  • Phone: 805-602-7931
  • Fax: 805-601-7932
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA20628
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: