Provider Demographics
NPI:1417283367
Name:VAZQUEZ, LILIA ELIZABETH (PA-C)
Entity Type:Individual
Prefix:MS
First Name:LILIA
Middle Name:ELIZABETH
Last Name:VAZQUEZ
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MS
Other - First Name:LILIA
Other - Middle Name:ELIZABETH
Other - Last Name:CASTRO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:12291 WASHINGTON BLVD
Mailing Address - Street 2:SUITE 205
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90606-2500
Mailing Address - Country:US
Mailing Address - Phone:562-789-5447
Mailing Address - Fax:562-789-4447
Practice Address - Street 1:12291 WASHINGTON BLVD
Practice Address - Street 2:SUITE 205
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90606-2500
Practice Address - Country:US
Practice Address - Phone:562-789-5447
Practice Address - Fax:562-789-4447
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-28
Last Update Date:2022-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA20631363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant