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General NPI Number Information
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NPI Number | 1821599804
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Entity Type | Organization
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Legal Business Name | JOSE DALPRAT A PROFESSIONAL MEDICAL CORPORATION
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Dates
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Enumeration Date | 02/23/2018
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Last Update Date | 02/23/2018
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Provider Practice Location Address
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Address Line | 6025 N FIGUEROA ST STE B
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City | LOS ANGELES
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State | CA
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Zip | 90042-1365
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Country | US
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Telephone | 323-507-2311
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Fax | 323-621-6188
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Provider Business Mailing Address
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Address Line | 6025 N FIGUEROA ST STE B
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City | LOS ANGELES
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State | CA
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Zip | 90042-1365
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Country | US
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Telephone | 323-507-2311
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Fax | 323-621-6188
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Authorized Official
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Title or Position | VICE PRESIDENT AND SECRETARY,
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Name | REBECA E CUATRO
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Credential | NP
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Telephone | 323-507-2311
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 20A11851
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 22666
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License Number State | CA
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