Individual
MARIZA DE PERALTA-VENTURINA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8700 BEVERLY BLVD, SUITE 8709, WEST HOLLYWOOD, CA 90048-1804
(310) 423-8650
(310) 423-0122
Mailing address
8700 BEVERLY BLVD, SUITE 8709, WEST HOLLYWOOD, CA 90048-1804
(310) 423-8650
(310) 423-0122
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
4301061120
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
220F362370
BCBSM
MI
05
—
4468203
—
MI
Enumeration date
03/20/2006
Last updated
05/13/2009
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