Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | A95634 | CA |
Y | 2080P0203X | Pediatric Critical Care Doctor | A95634 | CA |
NPI | 1043416621 |
---|---|
Provider Name | Dr. Mary Kathleen Mazel |
First Address | Chatsworth, CA 91311-2133 |
Second Address | Chatsworth, CA 91311-2133 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/06/2007 |
Last Update Date | 02/04/2015 |