Provider Demographics
NPI:1558404558
Name:NARVASA, OFELIA (MD)
Entity Type:Individual
Prefix:MS
First Name:OFELIA
Middle Name:
Last Name:NARVASA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3626 GRAND AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:CHINO HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91709-1478
Mailing Address - Country:US
Mailing Address - Phone:909-613-0058
Mailing Address - Fax:909-613-0144
Practice Address - Street 1:3626 GRAND AVE
Practice Address - Street 2:SUITE A
Practice Address - City:CHINO HILLS
Practice Address - State:CA
Practice Address - Zip Code:91709-1478
Practice Address - Country:US
Practice Address - Phone:909-613-0058
Practice Address - Fax:909-613-0144
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-15
Last Update Date:2008-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA73322207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A733222Medicare PIN
CAH51675Medicare UPIN