Provider Demographics
NPI:1558550343
Name:HINOJOSA, FEDERICO (PA)
Entity Type:Individual
Prefix:MR
First Name:FEDERICO
Middle Name:
Last Name:HINOJOSA
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1901 W BADILLO ST
Mailing Address - Street 2:
Mailing Address - City:WEST COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91790
Mailing Address - Country:US
Mailing Address - Phone:626-962-5625
Mailing Address - Fax:626-962-2566
Practice Address - Street 1:1901 W BADILLO ST
Practice Address - Street 2:
Practice Address - City:WEST COVINA
Practice Address - State:CA
Practice Address - Zip Code:91790-1133
Practice Address - Country:US
Practice Address - Phone:626-962-5625
Practice Address - Fax:626-962-2566
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-17
Last Update Date:2014-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA10150363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAR94256OtherUPIN