Provider Demographics
NPI:1356193023
Name:ROLDAN, LILLYA TERESA (MD)
Entity type:Individual
Prefix:
First Name:LILLYA
Middle Name:TERESA
Last Name:ROLDAN
Suffix:
Gender:F
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:HARBOR-UCLA MEDICAL CENTER OFFICE OF GME
Mailing Address - Street 2:1000 W. CARSON STREET, BOX 36
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90507-0036
Mailing Address - Country:US
Mailing Address - Phone:424-306-4000
Mailing Address - Fax:
Practice Address - Street 1:HARBOR-UCLA MEDICAL CENTER OFFICE OF GME
Practice Address - Street 2:1000 W. CARSON STREET, BOX 36
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90507
Practice Address - Country:US
Practice Address - Phone:424-306-4000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-04
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program