Basic Information
Provider Information
NPI: 1790021343
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BIGGANS
FirstName: EMELITA
MiddleName: LASCANO
NamePrefix:  
NameSuffix:  
Credential: F.N.P
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 5395 RUFFIN RD
Address2: SUITE 204
City: SAN DIEGO
State: CA
PostalCode: 921231338
CountryCode: US
TelephoneNumber: 8585713630
FaxNumber: 8585713649
Practice Location
Address1: 5395 RUFFIN RD
Address2: SUITE 204
City: SAN DIEGO
State: CA
PostalCode: 921231338
CountryCode: US
TelephoneNumber: 8585713630
FaxNumber: 8585713649
Other Information
ProviderEnumerationDate: 12/28/2012
LastUpdateDate: 12/28/2012
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LF0000XNP19523CAY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

No ID Information.


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