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General NPI Number Information
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NPI Number | 1518281625
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Entity Type | Individual
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Provider Name | LATONYA DENISE HITCHCOCK PA-C
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Gender | Female
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Dates
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Enumeration Date | 03/18/2010
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Last Update Date | 05/31/2016
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Provider Practice Location Address
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Address Line | 1414 SOUTH GRAND AVENUE SUITE 456
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City | LOS ANGELES
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State | CA
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Zip | 90015-3017
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Country | US
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Telephone | 213-745-6047
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Fax | 213-748-9715
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Provider Business Mailing Address
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Address Line | 4221 S ALAMEDA ST SUITE 456
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City | VERNON
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State | CA
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Zip | 90058-1601
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Country | US
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Telephone | 213-745-6047
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Fax | 213-748-9715
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 20753
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License Number State | CA
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