Individual
MR. LORD CHRISTOPHER BAGACINA LARCENA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
212 W GARFIELD AVE APT 108, GLENDALE, CA 91204-2146
(818) 296-5119
Mailing address
212 W GARFIELD AVE APT 108, GLENDALE, CA 91204-2146
(818) 296-5119
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
038246-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
021
—
FL
Enumeration date
02/16/2018
Last updated
02/16/2018
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