MEDICARE: HECTOR PINEDA

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	291U00000X	Clinical Medical Laboratory	05D1085761	CA

General Provider Information

NPI Number	:	1720236060
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HECTOR PINEDA

Provider Business Mailing Address
First Line	:	1335 N LA BREA AVE
Second Line	:	SUITE 2109
City	:	LOS ANGELES
State	:	CA
Zip	:	90028-7526
Country	:	US
Telephone Number	:	818-263-4321
Fax Number	:	818-479-9200

Provider Business Practice Location Address
First Line	:	1335 N LA BREA AVE
Second Line	:	SUITE 2109
City	:	LOS ANGELES
State	:	CA
Zip	:	90028-7526
Country	:	US
Telephone Number	:	818-263-4321
Fax Number	:	818-479-9200

Authorized Official
Title or Position	:	OWNER
Name	:	HECTOR PINEDA
Credential	:
Telephone Number	:	818-263-4321

Provider Enumeration Date	:	08/28/2008
Last Update Date	:	06/02/2009

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Directions to “HECTOR PINEDA ” Practice Location

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