Individual
MARISSA MAAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1441 EASTLAKE AVE STE 7416, LOS ANGELES, CA 90089-1020
(323) 865-3700
Mailing address
1441 EASTLAKE AVE STE 7416, LOS ANGELES, CA 90089-1020
(323) 865-3700
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
PTL6115
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NONE
N/A
—
Enumeration date
03/16/2020
Last updated
03/24/2022
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