Individual
MIA C VERBONITZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RVT, RDMS
Contact information
Practice address
29450 WOODEN BOAT DR, MENIFEE, CA 92585-9067
(760) 450-2792
Mailing address
29450 WOODEN BOAT DR, MENIFEE, CA 92585-9067
(760) 450-2792
Taxonomy
Speciality
Code
Description
License number
State
2085U0001X
Diagnostic Ultrasound Physician
Primary
104288
CA
2471V0105X
Vascular Sonography Radiologic Technologist
104288
CA
Other
Enumeration date
08/05/2019
Last updated
08/05/2019
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