Provider Demographics
NPI:1346721230
Name:PIMENTEL CARRASCO, OLGA EDITH (RCP)
Entity Type:Individual
Prefix:
First Name:OLGA
Middle Name:EDITH
Last Name:PIMENTEL CARRASCO
Suffix:
Gender:F
Credentials:RCP
Other - Prefix:
Other - First Name:OGA
Other - Middle Name:EDITH
Other - Last Name:PIMENTEL CARRASCO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RCP
Mailing Address - Street 1:714 S HOLLY AVE
Mailing Address - Street 2:
Mailing Address - City:COMPTON
Mailing Address - State:CA
Mailing Address - Zip Code:90221-4106
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:25825 VERMONT AVE
Practice Address - Street 2:
Practice Address - City:HARBOR CITY
Practice Address - State:CA
Practice Address - Zip Code:90710-3518
Practice Address - Country:US
Practice Address - Phone:310-517-2648
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-28
Last Update Date:2018-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA37396227900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Registered