Individual
MARINA VERGILIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
13326 MAXELLA AVE, UNIT 3, MARINA DEL REY, CA 90292-5639
(310) 593-4119
Mailing address
18370 BURBANK BLVD, SUITE 407, TARZANA, CA 91356-2804
(818) 996-4242
(818) 996-4352
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA18548
CA
Other
Enumeration date
06/26/2007
Last updated
01/18/2009
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