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General NPI Number Information
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NPI Number | 1184352312
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Entity Type | Organization
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Legal Business Name | AL PA CONSULTING
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Dates
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Enumeration Date | 08/15/2022
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Last Update Date | 09/19/2022
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Provider Practice Location Address
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Address Line | 47600 VIA MONTESSA
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City | LA QUINTA
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State | CA
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Zip | 92253-2134
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Country | US
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Telephone | 760-413-7258
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Fax |
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Provider Business Mailing Address
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Address Line | 47600 VIA MONTESSA
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City | LA QUINTA
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State | CA
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Zip | 92253-2134
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Country | US
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Telephone | 760-413-7258
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Fax |
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | MR. GAETH LOVATO JR.
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Credential | PA
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Telephone | 760-413-7258
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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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