Individual
MARIANITO PATAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CPT1
Contact information
Practice address
3101 LEGENDARIO, SAN CLEMENTE, CA 92673-3815
(949) 338-4976
(949) 542-4145
Mailing address
3101 LEGENDARIO, SAN CLEMENTE, CA 92673-3815
(949) 338-4976
(949) 542-4145
Taxonomy
Speciality
Code
Description
License number
State
246RP1900X
Phlebotomy Technician
Primary
CPT00005346
CA
Other
Enumeration date
01/23/2013
Last updated
01/23/2013
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