Individual
MARK LAWRENCE MOTOL SY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
411 N CARMELO AVE, PASADENA, CA 91107-2500
(626) 484-2538
Mailing address
411 N CARMELO AVE, PASADENA, CA 91107-2500
(213) 383-0050
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
95085268
CA
Other
Enumeration date
11/14/2018
Last updated
11/14/2018
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