Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207ND0900X | Dermatopathologist | G035270 | CA |
N | 207NS0135X | Procedural Dermatology | G035270 | CA |
NPI | 1831389964 |
---|---|
Provider Name | Marilyn Ann Mehlmauer |
First Address | Pasadena, CA 91105-3023 |
Second Address | Pasadena, CA 91105-3023 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/07/2007 |
Last Update Date | 16/06/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A46288 | (02) | CA |