Individual provider Active NPI

Lawrence Pangilinan, PA-C

  • Physician Assistant
  • El Monte, CA
National Provider Identifier
1760040422
Registry record updated May 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
56366 Issued in CA
Practice address
11436 Garvey Ave Ste a
El Monte, CA 91732-3304
Phone
(626) 459-5420
NPI assigned
May 29, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 9, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 56366 CA Primary

Addresses

Primary practice location

11436 Garvey Ave Ste a
El Monte, CA 91732-3304

Mailing address

11436 Garvey Ave Ste a
El Monte, CA 91732-3304
Phone (626) 459-5420

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210323002710 CA Practitioner - Physician Assistant 9234546060 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
56366CAMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Mayflower Medical Group, Inc. PastSince Jun 7, 2020 Accepting new patients
Children'S Hospital Los Angeles Past Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1559088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715212800000",
    "number": "1760040422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11436 GARVEY AVE STE A",
            "city": "EL MONTE",
            "state": "CA",
            "postal_code": "917323304",
            "telephone_number": "626-459-5420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11436 GARVEY AVE STE A",
            "city": "EL MONTE",
            "state": "CA",
            "postal_code": "917323304",
            "telephone_number": "626-459-5420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANGILINAN",
        "first_name": "LAWRENCE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-05-29",
        "last_updated": "2024-05-09",
        "certification_date": "2024-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "56366",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Monte, CA

Sources for this page

Verify at the official NPI Registry.