Provider Demographics
NPI:1073256558
Name:AREVALO, LUISA FERNANDA (MD)
Entity type:Individual
Prefix:DR
First Name:LUISA
Middle Name:FERNANDA
Last Name:AREVALO
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:11600 INDIAN HILLS RD
Mailing Address - Street 2:
Mailing Address - City:MISSION HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91345-1225
Mailing Address - Country:US
Mailing Address - Phone:818-838-4500
Mailing Address - Fax:818-838-7509
Practice Address - Street 1:11600 INDIAN HILLS RD
Practice Address - Street 2:
Practice Address - City:MISSION HILLS
Practice Address - State:CA
Practice Address - Zip Code:91345-1225
Practice Address - Country:US
Practice Address - Phone:818-838-4500
Practice Address - Fax:818-838-7509
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-14
Last Update Date:2025-07-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
390200000X
CAA189991207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program