Provider Demographics
NPI:1295310704
Name:IGNACIO, LESTER (NP)
Entity type:Individual
Prefix:
First Name:LESTER
Middle Name:
Last Name:IGNACIO
Suffix:
Gender:
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:5562 PHILADELPHIA ST STE 301
Mailing Address - Street 2:
Mailing Address - City:CHINO
Mailing Address - State:CA
Mailing Address - Zip Code:91710-2499
Mailing Address - Country:US
Mailing Address - Phone:713-589-5283
Mailing Address - Fax:
Practice Address - Street 1:6991 E CAMELBACK RD STE 300
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85251-2432
Practice Address - Country:US
Practice Address - Phone:408-518-2712
Practice Address - Fax:630-566-8294
Is Sole Proprietor?:No
Enumeration Date:2021-03-16
Last Update Date:2025-04-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FL11012138363LP2300X
CA95026627363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care