Doctor Name: | MAA VILI |
NPI Number: | 1376729772 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | N9429567 |
Business Practice Address: | 2043 242nd St Lomita, CA - 907171115 |
Business Phone Number: | 4242634485 |
Business Fax Number: | |
Mailing Address: | 340 E 229th Pl, CARSON |
State: | CA |
Postal Code: | 907454908 |
Phone Number: | 3105221064 |
Fax Number: | |
NPI Enumeration Date: | 01/15/2008 |
NPI Last Update Date: | 01/15/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 172A00000X |
License Number: | N9429567 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Driver |
Taxonomy Specialization: | |
Taxonomy Definition: | A person employed to operate a motor vehicle as a carrier of persons or property. |