Provider Demographics
NPI:1801239777
Name:ARMIJO, LILIA F
Entity type:Individual
Prefix:MRS
First Name:LILIA
Middle Name:F
Last Name:ARMIJO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:52565 HARRISON ST STE 106
Mailing Address - Street 2:
Mailing Address - City:COACHELLA
Mailing Address - State:CA
Mailing Address - Zip Code:92236-1534
Mailing Address - Country:US
Mailing Address - Phone:760-398-2000
Mailing Address - Fax:760-398-2011
Practice Address - Street 1:52565 HARRISON ST STE 106
Practice Address - Street 2:
Practice Address - City:COACHELLA
Practice Address - State:CA
Practice Address - Zip Code:92236-1534
Practice Address - Country:US
Practice Address - Phone:760-398-2000
Practice Address - Fax:760-398-2011
Is Sole Proprietor?:No
Enumeration Date:2013-04-10
Last Update Date:2013-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAB1002230152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist