Laxa, Maryanne Ian

Laxa, Maryanne Ian is an individual health care provider with primary practice located at 91275 66Th St , Mecca CA 92254. She recently has only one registered license in Allopathic & Osteopathic Physicians / Neonatal-Perinatal Medicine, which is considered as her primary health care specialty. Laxa, Maryanne Ian can be contacted via phone (760) 344-9951.

Contact Information

Primary practice address
91275 66Th St Mecca CA 92254
Phone: (760) 344-9951
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Neonatal-Perinatal Medicine 2080N0001X A76409 California

Profile Details

NPI number 1184716458
LBN Legal business name Laxa, Maryanne Ian
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 28th, 2006
Last updated Jan 25th, 2012 - about 12 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 1184716458 NPPES
California MEDICAID 00A764090

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