MEDICARE: MISS LUCIA PADILLA PHYSICIAN ASSISTANT

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	363A00000X	Physician Assistant	1085622	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1689829210
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS LUCIA PADILLA PHYSICIAN ASSISTANT

Provider Business Mailing Address
First Line	:	1061 E VERNON AVE STE F
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90011-3772
Country	:	US
Telephone Number	:	323-233-9686
Fax Number	:	323-233-0595

Provider Business Practice Location Address
First Line	:	1061 E VERNON AVE STE F
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90011-3772
Country	:	US
Telephone Number	:	323-233-9686
Fax Number	:	323-233-0595

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

Provider Enumeration Date	:	11/24/2008
Last Update Date	:	11/18/2021

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Directions to “ MISS LUCIA PADILLA PHYSICIAN ASSISTANT” Practice Location

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