Individual
MARK MASARU URATA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD DDS
Contact information
Practice address
4650 W SUNSET BLVD, LOS ANGELES, CA 90027-6062
(888) 631-2452
(323) 361-8988
Mailing address
PO BOX 31309, LOS ANGELES, CA 90031-0309
(323) 442-7920
Taxonomy
Speciality
Code
Description
License number
State
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
A64497
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A644970
—
CA
Enumeration date
09/14/2006
Last updated
12/20/2018
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