Divine, Lila T
Divine, Lila T is an sole proprietor health care provider with primary practice located at 24331 El Toro Rd Ste 200 , Laguna Woods CA 92637-3116. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Divine, Lila T can be contacted via phone (949) 586-3200.Contact Information
Primary practice address
24331 El Toro Rd Ste 200
Laguna Woods CA 92637-3116
Phone: (949) 586-3200
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | 60085 | California |
Profile Details
| NPI number | 1043883093 |
|---|---|
| LBN Legal business name | Divine, Lila T |
| Credentials | Physician Assistant (PA) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 19th, 2021 |
| Last updated | Jan 6th, 2022 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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