MEDICARE: ADRIANNA GAITAN

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	172V00000X	Community Health Worker		CA
2	171M00000X	Case Manager/Care Coordinator		NM

General Provider Information

NPI Number	:	1730825852
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ADRIANNA GAITAN

Provider Business Mailing Address
First Line	:	2650 E FOOTHILL BLVD
Second Line	:
City	:	PASADENA
State	:	CA
Zip	:	91107-3439
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1000 N ALAMEDA ST STE 390
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90012-1804
Country	:	US
Telephone Number	:	213-804-3139
Fax Number	:

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

Provider Enumeration Date	:	05/11/2022
Last Update Date	:	01/05/2026

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Directions to “ ADRIANNA GAITAN ” Practice Location

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