Organization
EMMANUEL N. MBA, M.D., INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EMMANUEL N MBA M.D. (PRESIDENT)
(310) 677-7172
Entity
Organization
Contact information
Practice address
325 E HILLCREST BLVD, INGLEWOOD, CA 90301-2405
(310) 677-7172
(310) 677-2658
Mailing address
5640 W 62ND ST, LOS ANGELES, CA 90056-2009
(310) 677-7172
(310) 677-2658
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
G19040
CA
Other
Enumeration date
03/11/2013
Last updated
03/11/2013
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