Individual
MS. JENNA LALAS EUGENIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
2097 COMPTON AVE STE 103, CORONA, CA 92881
(951) 934-0505
Mailing address
3943 IRVINE BLVD # 40, IRVINE, CA 92602-2400
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA21420
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ZZZ31642Z
MEDICARE GROUP ASSOCIATION
CA
Enumeration date
02/24/2011
Last updated
08/23/2018
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