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General NPI Number Information
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NPI Number | 1518547694
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Entity Type | Individual
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Provider Name | OLIVAR EMPERADO
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Gender | Male
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Dates
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Enumeration Date | 04/12/2021
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Last Update Date | 05/17/2021
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Provider Practice Location Address
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Address Line | 25061 MACKENZIE ST
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City | LAGUNA HILLS
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State | CA
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Zip | 92653-5082
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Country | US
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Telephone | 844-247-9111
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Fax |
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Provider Business Mailing Address
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Address Line | 24012 CALLE DE LA PLATA STE 400
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City | LAGUNA HILLS
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State | CA
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Zip | 92653-7623
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Country | US
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Telephone | 833-247-9111
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Fax | 949-215-0213
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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 | 172A00000X
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Taxonomy Name | Driver
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License Number | Y8507969
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License Number State | CA
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