Organization
MARY POONEN, M.D., INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY POONEN M.D. (OWNER)
(714) 544-9466
Entity
Organization
Contact information
Practice address
16052 BEACH BLVD, SUITE 214, HUNTINGTON BEACH, CA 92647-3801
(714) 544-9466
(714) 849-5482
Mailing address
36 LAURELWOOD, IRVINE, CA 92620-1299
(714) 544-9466
(714) 849-5482
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
MFC33147
CA
101YP2500X
Professional Counselor
Primary
CO41790
CA
Other
Enumeration date
12/06/2006
Last updated
07/07/2009
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