MEDICARE: DOLORES FIGUEROA M.D., A PROFESSIONAL CORPORATION

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
1	207R00000X	Internal Medicine Physician	A72888	CA

General Provider Information

NPI Number	:	1568885788
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DOLORES FIGUEROA M.D., A PROFESSIONAL CORPORATION

Provider Business Mailing Address
First Line	:	4623 EAGLE ROCK BLVD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90041-3049
Country	:	US
Telephone Number	:	323-340-1500
Fax Number	:	323-340-1511

Provider Business Practice Location Address
First Line	:	4623 EAGLE ROCK BLVD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90041-3049
Country	:	US
Telephone Number	:	323-340-1500
Fax Number	:	323-340-1511

Authorized Official
Title or Position	:	PHYSICIAN/OWNER
Name	:	DOLORES FIGUEROA
Credential	:	MD
Telephone Number	:	323-340-1500

Provider Enumeration Date	:	01/23/2014
Last Update Date	:	01/23/2014

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