Doctor Name: | ENRIQUE LAURO PADILLA |
NPI Number: | 1184028375 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | P.A. |
License Number: | PA16591 |
Business Practice Address: | 4312 Lindsey Ave Pico Rivera, CA - 90660 |
Business Phone Number: | 5626996317 |
Business Fax Number: | |
Mailing Address: | 4312 Lindsey Ave, PICO RIVERA |
State: | CA |
Postal Code: | 90660 |
Phone Number: | 5626996317 |
Fax Number: | |
NPI Enumeration Date: | 10/16/2014 |
NPI Last Update Date: | 10/16/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | PA16591 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |