Individual
MARK JOSEPH AJALAT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
200 UCLA MEDICAL PLZ STE 526, LOS ANGELES, CA 90095-8358
(310) 206-6294
Mailing address
5767 W CENTURY BLVD STE 400, LOS ANGELES, CA 90045-5631
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
A164475
CA
Other
Enumeration date
03/19/2018
Last updated
11/03/2023
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