Individual
MARCELLA C. MADRID
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CFM
Contact information
Practice address
320 E BONITA AVE, POMONA, CA 91767-1926
(909) 621-1180
(909) 624-1650
Mailing address
320 E BONITA AVE, POMONA, CA 91767-1926
(909) 621-1180
(909) 624-1650
Taxonomy
Speciality
Code
Description
License number
State
224900000X
Mastectomy Fitter
Primary
CFM02274
CA
Other
Enumeration date
10/26/2010
Last updated
08/04/2011
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