Provider Demographics
NPI:1467286187
Name:SAGARIO, LAVINIA CASTILLO (PA-C)
Entity type:Individual
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First Name:LAVINIA
Middle Name:CASTILLO
Last Name:SAGARIO
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Gender:F
Credentials:PA-C
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Mailing Address - Street 1:14650 AVIATION BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:HAWTHORNE
Mailing Address - State:CA
Mailing Address - Zip Code:90250-6670
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1820 FULLERTON AVE STE 115
Practice Address - Street 2:
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92881-3113
Practice Address - Country:US
Practice Address - Phone:323-306-9632
Practice Address - Fax:323-268-6738
Is Sole Proprietor?:No
Enumeration Date:2024-08-27
Last Update Date:2025-05-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CA363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant