Mioux Berry, Mary A

Mioux Berry, Mary A is an individual health care provider with primary practice located at 630 S Raymond Ave Suite #120, Pasadena CA 91105-3278. She recently has only one registered license in Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation, which is considered as her primary health care specialty. Mioux Berry, Mary A can be contacted via phone (626) 403-1444.

Contact Information

Primary practice address
630 S Raymond Ave Suite #120 Pasadena CA 91105-3278
Phone: (626) 403-1444
Fax: (626) 403-1448
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation 208100000X 036084547 Illinois
Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation 208100000X 20A8359 California

Profile Details

NPI number 1023014750
LBN Legal business name Mioux Berry, Mary A
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 27th, 2005
Last updated Oct 8th, 2009 - about 16 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 1023014750 NPPES
Illinois Other 250004104 RAILROAD MEDICAID
Illinois Other 0006005217 RAILROAD MEDICAID

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