Provider Demographics
NPI:1922238112
Name:EQUIHUA, PAULINO ANTONIO (MD)
Entity Type:Individual
Prefix:DR
First Name:PAULINO
Middle Name:ANTONIO
Last Name:EQUIHUA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7107 NADA ST
Mailing Address - Street 2:
Mailing Address - City:DOWNEY
Mailing Address - State:CA
Mailing Address - Zip Code:90242-2006
Mailing Address - Country:US
Mailing Address - Phone:562-928-5882
Mailing Address - Fax:
Practice Address - Street 1:7107 NADA ST
Practice Address - Street 2:
Practice Address - City:DOWNEY
Practice Address - State:CA
Practice Address - Zip Code:90242-2006
Practice Address - Country:US
Practice Address - Phone:562-928-5882
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-22
Last Update Date:2021-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA102615207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine