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Organization
MARY JO FORD MD INC
Active
Organization
MARY JO FORD MD INC
Active
Other names
Phoenix Pain Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
MARY JO FORD MD (PRESIDENT)
(310) 374-4100
Entity
Organization
Contact information
Practice address
555 PIER AVENUE, SUITE 1, HERMOSA BEACH, CA 90254-3800
(310) 374-4100
(310) 374-4111
Mailing address
555 PIER AVENUE, SUITE 1, HERMOSA BEACH, CA 90254-3800
(310) 374-4100
(310) 374-4111
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
G73858
CA
Other
Enumeration date
11/28/2006
Last updated
05/29/2013
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