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Edgar Avilez Lara

Community Health Worker in Torrance, CA. Individual provider (NPI-1).

NPI number1538996004
StatusActive
Last updated in NPPESSep 30, 2024

Details

NPI
1538996004
Entity type
Individual (NPI-1)
Name
Edgar Avilez Lara
Sex
Male
Sole proprietor
No
Enumeration date
Sep 18, 2024
Certification date
Sep 30, 2024
Last updated
Sep 30, 2024

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
172V00000X Community Health Worker––Yes
171M00000X Case Manager/Care Coordinator––

Practice location

22728 Harvard Blvd Apt 30
Torrance, CA 90501-4932

Phone 310-869-9821

Mailing address

22728 Harvard Blvd Apt 30
Torrance, CA 90501-4932

Phone 310-869-9821

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