Individual
MS. COURTNEY MAE MANNINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
757 WESTWOOD PLZ, B711 RRUMC, LOS ANGELES, CA 90095
(310) 267-9129
Mailing address
PO BOX 512717, LOS ANGELES, CA 90051-0717
(310) 967-1884
(310) 937-1773
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
A146341
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/25/2015
Last updated
07/03/2018
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