Provider Information for 1972868669
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Ms. MARJORIE GEORGE
Sex: Female
NPI: 1972868669
Last Updated: 2024-10-21
Certification Date: 2024-10-21
Certification Date: 2024-10-21
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1972868669 | ||||||||
| Enumeration Date | 2012-07-09 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 2201 N LAKEWOOD BLVD # D-698 LONG BEACH, CA 90815-2552 United States Phone: 310-795-0869 | Fax: | ||||||||
| Primary Practice Address | 2121 W. TEMPLE AVE LOS ANGELES, CA 90026 United States Phone: 213-260-7728 | Fax: | ||||||||
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