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General NPI Number Information
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NPI Number | 1023591450
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Entity Type | Individual
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Provider Name | KATHERINE LILLY BOYD-CORDOVA PA-C
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Gender | Female
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Dates
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Enumeration Date | 09/11/2018
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Last Update Date | 05/17/2023
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Provider Practice Location Address
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Address Line | 9918 KATELLA AVE STE A-C
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City | ANAHEIM
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State | CA
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Zip | 92804-6465
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Country | US
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Telephone | 714-644-9494
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Fax | 714-644-9894
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Provider Business Mailing Address
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Address Line | PO BOX 98978
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City | LAS VEGAS
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State | NV
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Zip | 89193-8978
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Country | US
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Telephone | 702-216-3346
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Fax | 702-671-6883
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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 | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number |
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License Number State |
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