Organization
PRIM HEALTH SERVICES INC
Active
Organization
PRIM HEALTH SERVICES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHEN D MABERRY M.D. (PRESIDENT)
(213) 995-5054
Entity
Organization
Contact information
Practice address
5150 WILSHIRE BLVD, SUITE 603, LOS ANGELES, CA 90036-4303
(213) 995-5054
(213) 652-1908
Mailing address
1317 N SAN FERNANDO BLVD, 301, BURBANK, CA 91504-4236
(213) 995-5054
(213) 652-1908
Taxonomy
Speciality
Code
Description
License number
State
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
A72562
CA
Other
Enumeration date
10/09/2009
Last updated
10/09/2009
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