MEDICARE: PATRICIA ARELLANO LVN

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	164X00000X	Licensed Vocational Nurse	VN 2236681	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	PL20428	OTHER	CA	PL#

General Provider Information

NPI Number	:	1578688172
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PATRICIA ARELLANO LVN

Provider Business Mailing Address
First Line	:	3491 KURTZ ST STE 150
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92110-4430
Country	:	US
Telephone Number	:	619-320-2404
Fax Number	:

Provider Business Practice Location Address
First Line	:	3491 KURTZ ST STE 150
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92110-4430
Country	:	US
Telephone Number	:	619-320-2404
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/20/2007
Last Update Date	:	01/05/2023

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