Healthcare Provider Details

I. General information

NPI: 1851998579
Provider Name (Legal Business Name): LIA KATHRYN ZAPPALA PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/06/2020
Last Update Date: 04/01/2024
Certification Date: 04/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14350 WHITTIER BLVD STE 100
WHITTIER CA
90605-2122
US

IV. Provider business mailing address

14350 WHITTIER BLVD STE 100
WHITTIER CA
90605-2122
US

V. Phone/Fax

Practice location:
  • Phone: 562-907-7600
  • Fax: 562-907-7602
Mailing address:
  • Phone: 562-907-7600
  • Fax: 562-907-7602

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number085007954
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: