Provider Demographics
NPI:1396865333
Name:PINEDA, HECTOR NARCISO (PA-C)
Entity Type:Individual
Prefix:MR
First Name:HECTOR
Middle Name:NARCISO
Last Name:PINEDA
Suffix:
Gender:M
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 1:4207 SLAUSON AVE
Mailing Address - Street 2:
Mailing Address - City:MAYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90270-2835
Mailing Address - Country:US
Mailing Address - Phone:323-560-1100
Mailing Address - Fax:323-560-1333
Practice Address - Street 1:15718 PARAMOUNT BLVD
Practice Address - Street 2:
Practice Address - City:PARAMOUNT
Practice Address - State:CA
Practice Address - Zip Code:90723-4352
Practice Address - Country:US
Practice Address - Phone:562-634-2111
Practice Address - Fax:562-634-2112
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-31
Last Update Date:2012-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA17156363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPA17156OtherPA