Provider Demographics
NPI:1427621606
Name:NUMATA, LINDSAY AIKO (MPAS, PA-C, MS)
Entity type:Individual
Prefix:
First Name:LINDSAY
Middle Name:AIKO
Last Name:NUMATA
Suffix:
Gender:F
Credentials:MPAS, PA-C, MS
Other - Prefix:
Other - First Name:LINDSAY
Other - Middle Name:AIKO
Other - Last Name:NUMATA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MPAS, PA-C, MS
Mailing Address - Street 1:6046 ORANGE AVE
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:CA
Mailing Address - Zip Code:90630-3329
Mailing Address - Country:US
Mailing Address - Phone:714-329-4761
Mailing Address - Fax:
Practice Address - Street 1:6046 ORANGE AVE
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:CA
Practice Address - Zip Code:90630-3329
Practice Address - Country:US
Practice Address - Phone:714-329-4761
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-23
Last Update Date:2021-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant