Provider Demographics
NPI:1518041359
Name:BAQUIRAN, PAULINA MENDOZA (MD)
Entity type:Individual
Prefix:DR
First Name:PAULINA
Middle Name:MENDOZA
Last Name:BAQUIRAN
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:1321 NO VERMONT AVENUE
Mailing Address - Street 2:SUITE C
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90027
Mailing Address - Country:US
Mailing Address - Phone:323-666-2304
Mailing Address - Fax:323-666-7524
Practice Address - Street 1:1321 NO VERMONT AVENUE
Practice Address - Street 2:SUITE C
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90027
Practice Address - Country:US
Practice Address - Phone:323-666-2304
Practice Address - Fax:323-666-7524
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA37167208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A371671Medicaid