Doctor Name: | DR. MARA COLOMA |
NPI Number: | 1023184132 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MD |
License Number: | A45090 |
Business Practice Address: | 6347 Pacific Blvd Huntington Park, CA - 902554101 |
Business Phone Number: | 3235838383 |
Business Fax Number: | 3235838399 |
Mailing Address: | Po Box 10432, BEVERLY HILLS |
State: | CA |
Postal Code: | 902133432 |
Phone Number: | 2136372530 |
Fax Number: | 2133843373 |
NPI Enumeration Date: | 11/28/2006 |
NPI Last Update Date: | 05/14/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | A45090 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |