Provider Demographics
NPI:1184766974
Name:AMADOR, CARLOS (LVN)
Entity type:Individual
Prefix:
First Name:CARLOS
Middle Name:
Last Name:AMADOR
Suffix:
Gender:M
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2500 WHITTIER BLVD
Mailing Address - Street 2:SUITE 3025
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90023-1307
Mailing Address - Country:US
Mailing Address - Phone:231-639-2500
Mailing Address - Fax:213-365-2813
Practice Address - Street 1:2500 WILSHIRE BLVD
Practice Address - Street 2:S
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90057-4303
Practice Address - Country:US
Practice Address - Phone:231-639-2500
Practice Address - Fax:213-365-2813
Is Sole Proprietor?:No
Enumeration Date:2007-02-12
Last Update Date:2014-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAVN216407164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAVN216407OtherLVN