Organization Name: | MARTA BLESA MD A PROFESSIONAL CORPORATION |
NPI Number: | 1972819977 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | TINA RAMIREZ (OFFICE MANAGER) |
Mailing Address: | 5821 Temple City Blvd Temple City |
State: | CA US |
Postal Code: | 917802113 |
Phone Number: | 6262878261 |
Fax Number: | |
NPI Enumeration Date: | 08/27/2010 |
NPI Last Update Date: | 01/03/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | A31530 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |