| Maria Lourdes S Mara Md - A Medical Corp | |
|
2939 Alta View Dr Ste J San Diego CA 92139-3394 | |
| (619) 475-5411 | |
| (619) 475-1839 |
| Full Name | Maria Lourdes S Mara Md - A Medical Corp |
|---|---|
| Speciality | Clinic/Center |
| Location | 2939 Alta View Dr Ste J, San Diego, California |
| Authorized Official Name and Position | Maria Lourdes De Los Santos Mara (PRESIDENT) |
| Authorized Official Contact | 6194755411 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Maria Lourdes S Mara Md - A Medical Corp 2939 Alta View Dr Ste J San Diego CA 92139-3394 Ph: (619) 475-5411 | Maria Lourdes S Mara Md - A Medical Corp 2939 Alta View Dr Ste J San Diego CA 92139-3394 Ph: (619) 475-5411 |
| NPI Number | 1679890644 |
|---|---|
| Provider Enumeration Date | 04/29/2010 |
| Last Update Date | 03/09/2011 |
| Medicare PECOS PAC ID | 3375677008 |
|---|---|
| Medicare Enrollment ID | O20100817001386 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679890644 | NPI | - | NPPES |
| 00A518642 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | A51864 (* (Not Available)) | Primary |
| Provider Name | Maria Lourdes Mara |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1376515924 PECOS PAC ID: 8628102258 Enrollment ID: I20100817001431 |
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