Provider Demographics
NPI:1972939007
Name:ROJAS, LORRAINE (PA-C)
Entity Type:Individual
Prefix:
First Name:LORRAINE
Middle Name:
Last Name:ROJAS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23451 MADISON ST
Mailing Address - Street 2:STE 340
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505-4762
Mailing Address - Country:US
Mailing Address - Phone:310-373-6864
Mailing Address - Fax:310-373-6065
Practice Address - Street 1:23451 MADISON ST
Practice Address - Street 2:STE 340
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-4762
Practice Address - Country:US
Practice Address - Phone:310-373-6864
Practice Address - Fax:310-373-6065
Is Sole Proprietor?:No
Enumeration Date:2013-09-20
Last Update Date:2016-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY016989-1363AM0700X, 363AS0400X
CA53541363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical