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Individual

MR. MARLO A HERRERA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MPAS, PA-C

Contact information

Practice address
5823 YORK BLVD, #1, LOS ANGELES, CA 90042-2634
(323) 255-1575
(323) 255-8139
Mailing address
5823 YORK BLVD, #1, LOS ANGELES, CA 90042-2634

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA19183
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
PA19183
PA LICENSE
CA
Enumeration date
07/12/2007
Last updated
11/17/2007
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