Provider Demographics
NPI:1639460322
Name:PO-GARCIA, LILLIANA (NP)
Entity Type:Individual
Prefix:
First Name:LILLIANA
Middle Name:
Last Name:PO-GARCIA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:LILLIANA
Other - Middle Name:
Other - Last Name:PO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5767 W CENTURY BLVD STE 400
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90045-5631
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1260 15TH ST STE 1501
Practice Address - Street 2:
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90404-1150
Practice Address - Country:US
Practice Address - Phone:310-656-1701
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-28
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA559134163W00000X
CA13800363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163W00000XNursing Service ProvidersRegistered Nurse