Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223D0004X | Dentist Anesthesiologist | 44255 | CA |
NPI | 1952451106 |
---|---|
Provider Name | Dr. Mary Perez Satuito |
First Address | Los Angeles, CA 90037-2658 |
Second Address | Los Angeles, CA 90037-2658 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/01/2007 |
Last Update Date | 14/09/2013 |