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Individual

DR. MARY JO VITA URSO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
D.O.

Contact information

Practice address
1515 W FLORIDA AVE, HEMET, CA 92543
(951) 929-8400
(951) 929-8411
Mailing address
1515 W FLORIDA AVE, HEMET, CA 92543-3817
(951) 929-8400
(951) 929-8411

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
20A8265
CA
207V00000X
Obstetrics & Gynecology Physician
3696
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
635526
AZ
Enumeration date
07/08/2005
Last updated
08/29/2018
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