Provider Demographics
NPI:1558493536
Name:LAW, IRINA HOGHOUGHI (FNP)
Entity Type:Individual
Prefix:MISS
First Name:IRINA
Middle Name:HOGHOUGHI
Last Name:LAW
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:6956 QUIET COVE DR
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92011-3729
Mailing Address - Country:US
Mailing Address - Phone:562-639-9348
Mailing Address - Fax:
Practice Address - Street 1:1751 E GARRY AVE
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92705-5814
Practice Address - Country:US
Practice Address - Phone:877-896-7350
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-12
Last Update Date:2019-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA6700363LF0000X
CARN388522363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
BI674ZMedicare PIN