Basic Information
| Provider Information | |||||||||
| NPI: | 1982060331 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PLETE | ||||||||
| FirstName: | ARWIN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 12015 CARL ST | ||||||||
| Address2: | |||||||||
| City: | SYLMAR | ||||||||
| State: | CA | ||||||||
| PostalCode: | 913426447 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8189346689 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2123 VERDUGO BLVD | ||||||||
| Address2: | |||||||||
| City: | MONTROSE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 910201628 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8182493925 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/14/2016 | ||||||||
| LastUpdateDate: | 01/14/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 172V00000X | AT 8168 | CA | Y | Other Service Providers | Community Health Worker |
No ID Information.