Provider Demographics
NPI:1780103085
Name:PAJARES, PAOLA CECILIA
Entity type:Individual
Prefix:
First Name:PAOLA
Middle Name:CECILIA
Last Name:PAJARES
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 1:5851 BEACH DRIVE LA 330
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90840-0001
Mailing Address - Country:US
Mailing Address - Phone:909-450-4076
Mailing Address - Fax:
Practice Address - Street 1:5851 BEACH DR
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90815-4146
Practice Address - Country:US
Practice Address - Phone:909-450-4076
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-18
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program