De Peralta-Venturina, Mariza

De Peralta-Venturina, Mariza is an individual health care provider with primary practice located at 8700 Beverly Blvd Suite 8709, West Hollywood CA 90048-1804. She recently has only one registered license in Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology, which is considered as her primary health care specialty. De Peralta-Venturina, Mariza can be contacted via phone (310) 423-8650.

Contact Information

Primary practice address
8700 Beverly Blvd Suite 8709 West Hollywood CA 90048-1804
Phone: (310) 423-8650
Fax: (310) 423-0122
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology 207ZP0102X 4301061120 Michigan

Profile Details

NPI number 1326007253
LBN Legal business name De Peralta-Venturina, Mariza
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 20th, 2006
Last updated May 13th, 2009 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1326007253 NPPES
Michigan Other 220F362370 BCBSM
Michigan MEDICAID 4468203 BCBSM

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