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NPI Code Detail

MEDICARE: PAUL LLAMOSO NP-C

MEDICARE: PAUL LLAMOSO NP-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner95011310CA

General Provider Information

NPI Number : 1184185290
Entity Type Code : Individual
Provider Name (Legal Business Name) : PAUL LLAMOSO NP-C
Provider Business Mailing Address
First Line : 22423 FRIES AVE
Second Line :
City : CARSON
State : CA
Zip : 90745-4015
Country : US
Telephone Number : 310-347-6614
Fax Number :
Provider Business Practice Location Address
First Line : 3045 E FLORENCE AVE
Second Line :
City : HUNTINGTON PARK
State : CA
Zip : 90255-5837
Country : US
Telephone Number : 323-587-7771
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/29/2019
Last Update Date : 03/29/2019

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