Provider Demographics
NPI:1992444376
Name:PASTRANA, FREYDER (IOMT)
Entity type:Individual
Prefix:
First Name:FREYDER
Middle Name:
Last Name:PASTRANA
Suffix:
Gender:M
Credentials:IOMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1231 CABRILLO AVE STE 203
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90501-2867
Mailing Address - Country:US
Mailing Address - Phone:310-543-7779
Mailing Address - Fax:
Practice Address - Street 1:1231 CABRILLO AVE STE 201A
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90501-2867
Practice Address - Country:US
Practice Address - Phone:310-543-7779
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-02
Last Update Date:2022-06-02
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnostic