Individual provider · Type 1 NPI
Lupe Tarango Portugal, PA
Medical Physician Assistant · Los Angeles, CA
NPI number
1083790489
Active
Practice location
317 S La Verne Ave
Los Angeles, CA 90022-1932
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Medical Physician Assistant Primary | 363AM0700X | PA10632 (CA) |
Medical Physician Assistant: Definition to come...
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About NPI 1083790489
Lupe Tarango Portugal, PA's National Provider Identifier is 1083790489, issued on Oct 27, 2006. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Los Angeles, CA. The record was last updated on Jul 8, 2007.