Individual
MS. LUPE TARANGO PORTUGAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
317 S LA VERNE AVE, LOS ANGELES, CA 90022-1932
(323) 496-3303
Mailing address
317 S LA VERNE AVE, LOS ANGELES, CA 90022-1932
(323) 496-3303
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA10632
CA
Other
Enumeration date
10/27/2006
Last updated
07/08/2007
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