Mary Jennifer Derebery

NPI 1457440992 - Otolaryngology - 207YX0602X

NPI Details
NPI 1457440992
Gender Female
Enumeration Date 10/12/2006
Last Updated 08/15/2013
Entity Type Individual
Active Over 10 years ago
Practice Location
2100 W 3RD ST
SUITE 111
LOS ANGELES CA, 90057-1944, US
Phone (213) 483-9930
Fax (213) 483-0905
Business Location
2100 W 3RD ST
SUITE 111
LOS ANGELES CA, 90057-1944, US
Phone (213) 483-9930
Fax (213) 483-0905
Toxanomy
Taxonomy Code 207YX0602X
License State California
License Number C42073
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According to our database, Dr. Mary Jennifer Derebery NPI is 1457440992, taxonomy code is 207YX0602X and license number is C42073, license state is located at California. Mary Jennifer Derebery physically located at 2100 W 3rd St, Los Angeles CA, 90057-1944. NPI Number Mary Jennifer Derebery has the Individual type.

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1457440992 NPI number is provided on an as is basis without warranty of any kind. 1457440992 is maintained by the National Plan & Provider Enumeration System. The contents of Mary Jennifer Derebery are for informational purposes only.