Provider Demographics
NPI:1205987286
Name:IGNATCZYK, LINDSAY NICOLE (PA)
Entity type:Individual
Prefix:
First Name:LINDSAY
Middle Name:NICOLE
Last Name:IGNATCZYK
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:LINDSAY
Other - Middle Name:NICOLE
Other - Last Name:PARSONS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:PO BOX 80116
Mailing Address - Street 2:
Mailing Address - City:CITY OF INDUSTRY
Mailing Address - State:CA
Mailing Address - Zip Code:91716-8116
Mailing Address - Country:US
Mailing Address - Phone:800-749-4560
Mailing Address - Fax:405-749-4557
Practice Address - Street 1:501 S BUENA VISTA ST
Practice Address - Street 2:EM DEPT
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91505-4809
Practice Address - Country:US
Practice Address - Phone:800-749-4560
Practice Address - Fax:405-749-4557
Is Sole Proprietor?:No
Enumeration Date:2007-01-16
Last Update Date:2021-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA18468363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPA18468Medicaid
CAPA18468Medicaid