Individual
MARIETYA IVOUNE SETIAWATI LAUW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
4002 VISTA WAY, OCEANSIDE, CA 92056-4506
(760) 940-7921
Mailing address
12622 TORREY BLUFF DR APT 337, SAN DIEGO, CA 92130-4202
(858) 260-9206
Taxonomy
Speciality
Code
Description
License number
State
207ZH0000X
Hematology (Pathology) Physician
A163715
CA
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
A163715
CA
Other
Enumeration date
03/28/2017
Last updated
07/31/2023
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