Individual
DR. MARCIL M MAMITA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3655 LOMITA BLVD STE 418, TORRANCE, CA 90505-1934
(310) 530-6900
(310) 530-6902
Mailing address
941 STANFORD ST, SANTA MONICA, CA 90403-2223
(310) 490-6954
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
A72411
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0072411
—
CA
Enumeration date
08/08/2006
Last updated
03/08/2019
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