Provider Demographics
NPI:1710658083
Name:PILOTOS, PAULINA BIANCA SAGARAL
Entity Type:Individual
Prefix:MRS
First Name:PAULINA BIANCA
Middle Name:SAGARAL
Last Name:PILOTOS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:620 DEL MONTE ST
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91103-2031
Mailing Address - Country:US
Mailing Address - Phone:626-318-5182
Mailing Address - Fax:
Practice Address - Street 1:6000 N FIGUEROA ST
Practice Address - Street 2:
Practice Address - City:HIGHLAND PARK
Practice Address - State:CA
Practice Address - Zip Code:90042-4232
Practice Address - Country:US
Practice Address - Phone:866-616-9344
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-25
Last Update Date:2021-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95017549363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily