Provider Demographics
NPI:1083242952
Name:HURTADO, JULIA ANDREA (PA-C)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:ANDREA
Last Name:HURTADO
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3783 CIMARRON ST
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90018-4463
Mailing Address - Country:US
Mailing Address - Phone:772-233-5150
Mailing Address - Fax:
Practice Address - Street 1:3783 CIMARRON ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90018-4463
Practice Address - Country:US
Practice Address - Phone:772-233-5150
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-27
Last Update Date:2020-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant