Provider Demographics
NPI:1518281625
Name:HITCHCOCK, LATONYA DENISE (PA-C)
Entity Type:Individual
Prefix:MISS
First Name:LATONYA
Middle Name:DENISE
Last Name:HITCHCOCK
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Gender:F
Credentials:PA-C
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Mailing Address - Street 1:4221 S ALAMEDA ST
Mailing Address - Street 2:SUITE 456
Mailing Address - City:VERNON
Mailing Address - State:CA
Mailing Address - Zip Code:90058-1601
Mailing Address - Country:US
Mailing Address - Phone:213-745-6047
Mailing Address - Fax:213-748-9715
Practice Address - Street 1:1414 SOUTH GRAND AVENUE
Practice Address - Street 2:SUITE 456
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90015-3017
Practice Address - Country:US
Practice Address - Phone:213-745-6047
Practice Address - Fax:213-748-9715
Is Sole Proprietor?:No
Enumeration Date:2010-03-18
Last Update Date:2016-05-31
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Provider Licenses
StateLicense IDTaxonomies
CA20753363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical