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General NPI Number Information
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NPI Number | 1003652264
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Entity Type | Individual
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Provider Name | LUIS FERNANDO PASTEN MD
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Gender | Male
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Dates
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Enumeration Date | 07/06/2024
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Last Update Date | 07/06/2024
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Provider Practice Location Address
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Address Line | BOULEVARD DE LAS BELLAS ARTES 19315, NUEVA TIJUANA BOULEVAD DE LAS BELLAS ARTES 19315, NUEVA TIJUANA
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City | TIJUANA
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State | MEXICO
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Zip | 22435
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Country | MX
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Telephone | 664-873-2811
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Fax |
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Provider Business Mailing Address
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Address Line | 1752 FERNWOOD RD
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City | CHULA VISTA
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State | CA
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Zip | 91913-1563
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Country | US
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Telephone | 619-493-9457
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0127X
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Taxonomy Name | Trauma Surgery Physician
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License Number | 09181235
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License Number State | ZZ
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