Lydia Amador

Individual provider Active NPI Physician Assistant · South Pasadena, CA

NPI 1326858366 · NPPES record last updated Feb 10, 2025

Key facts

NPI
1326858366
Entity type
Individual (NPI type 1)
Primary specialty
Physician Assistant 363A00000X
Practice address
1001 Fremont Ave # 267
South Pasadena, CA 91030-3224
Phone
(626) 354-3471
NPI assigned
Jan 11, 2025
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Physician Assistant 363A00000X CA Yes

Addresses

Primary practice location

1001 Fremont Ave # 267
South Pasadena, CA 91030-3224

Mailing address

1001 Fremont Ave # 267
South Pasadena, CA 91030-3224

Other providers in South Pasadena, CA

All providers in South Pasadena, CA · Physician Assistant in California

Sources for this page

Verify at the official NPI Registry.