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Organization

DEL-CARMEN MEDICAL GROUP

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. MARVIN PIETRUSZKA M.D. (MEDICAL DOCTOR)
(310) 914-9150
Entity
Organization

Contact information

Practice address
19234 VANOWEN ST, RESEDA, CA 91335-5000
(310) 914-9150
(310) 914-9750
Mailing address
19234 VANOWEN ST, RESEDA, CA 91335-5000
(310) 914-9150
(310) 914-9750

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
A30858
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00A308580
CA
Enumeration date
08/16/2006
Last updated
08/20/2010
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