Individual
MARY KORTO OMEZE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5850 S MAIN ST, LOS ANGELES, CA 90003-1215
(323) 897-6105
Mailing address
3618 W 133RD ST, HAWTHORNE, CA 90250-8981
(323) 897-6105
Taxonomy
Speciality
Code
Description
License number
State
163WP2201X
Ambulatory Care Registered Nurse
Primary
790475
CA
Other
Enumeration date
10/21/2025
Last updated
10/21/2025
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