Provider Demographics
NPI:1356496285
Name:PACIFICAR, ESTELLA ADORADOR (MD)
Entity Type:Individual
Prefix:
First Name:ESTELLA
Middle Name:ADORADOR
Last Name:PACIFICAR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ESTELLA
Other - Middle Name:KOLBE
Other - Last Name:ADORADOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:222 N SUNSET AVE
Mailing Address - Street 2:SUITE F
Mailing Address - City:WEST COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91790-2278
Mailing Address - Country:US
Mailing Address - Phone:626-960-0696
Mailing Address - Fax:626-960-5909
Practice Address - Street 1:222 N SUNSET AVE
Practice Address - Street 2:SUITE F
Practice Address - City:WEST COVINA
Practice Address - State:CA
Practice Address - Zip Code:91790-2278
Practice Address - Country:US
Practice Address - Phone:626-960-0696
Practice Address - Fax:626-960-5909
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA25445207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A254450Medicaid
CA00A254450Medicaid
CAW19278Medicare ID - Type Unspecified