Individual
ANDREA BANUELOS MOTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1920 COLORADO AVE, SANTA MONICA, CA 90404-3414
(310) 319-4700
Mailing address
1920 COLORADO AVE, SANTA MONICA, CA 90404-3414
(310) 319-4700
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
03/26/2021
Last updated
10/15/2024
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