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General NPI Number Information
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NPI Number | 1679056451
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Entity Type | Individual
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Provider Name | CHRISTINA ANN LAGAZO NP
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Gender | Female
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Dates
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Enumeration Date | 09/08/2018
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Last Update Date | 10/15/2024
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Provider Practice Location Address
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Address Line | 1115 S SUNSET AVE
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City | WEST COVINA
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State | CA
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Zip | 91790-3940
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Country | US
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Telephone | 626-814-2534
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Fax |
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Provider Business Mailing Address
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Address Line | 17049 E FRANCISQUITO AVE
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City | WEST COVINA
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State | CA
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Zip | 91791-3828
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Country | US
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Telephone | 808-268-9054
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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 | 207PE0004X
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Taxonomy Name | Emergency Medical Services (Emergency Medicine) Physician
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License Number | NP95009779
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 95009779
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License Number State | CA
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