Organization
MARIA LOURDES S MARA MD - A MEDICAL CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARIA LOURDES DE LOS SANTOS MARA M.D. (PRESIDENT)
(619) 475-5411
Entity
Organization
Contact information
Practice address
2939 ALTA VIEW DR STE J, SAN DIEGO, CA 92139-3394
(619) 475-5411
(619) 475-1839
Mailing address
2939 ALTA VIEW DR STE J, SAN DIEGO, CA 92139-3394
(619) 475-5411
(619) 475-1839
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
A51864
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A518642
—
CA
Enumeration date
04/29/2010
Last updated
03/09/2011
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