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Individual

MYRON C MARIANO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
412 W CARROLL AVE, SUITE 106, GLENDORA, CA 91741-4240
(626) 963-6026
(626) 963-5094
Mailing address
412 W CARROLL AVE, SUITE 106, GLENDORA, CA 91741-4240
(626) 963-6026
(626) 963-5094

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
G79760
CA
208600000X
Surgery Physician
L6241
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
16100901
TX
Enumeration date
11/10/2005
Last updated
10/27/2023
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