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Organization
MARIE MBOUNI M.D A MEDICAL CORPORATION
Active
Organization
MARIE MBOUNI M.D A MEDICAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARIE T. MBOUNI-ESSOMBA M.D (PRESIDENT)
(218) 233-3421
Entity
Organization
Contact information
Practice address
3751 KATELLA AVE, LOS ALAMITOS, CA 90720-3101
(562) 799-3160
(562) 799-3133
Mailing address
101 S 1ST ST, SUITE #1000, BURBANK, CA 91502-1938
(818) 845-6206
(818) 845-9774
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
C52701
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00C527010
BLUE SHIELD
CA
Enumeration date
09/15/2008
Last updated
12/30/2008
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