MEDICARE: DR. MAYRA CONTRERAS M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician	A94540	CA

General Provider Information

NPI Number	:	1295913630
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MAYRA CONTRERAS M.D.

Provider Business Mailing Address
First Line	:	2683 PACIFIC AVE
Second Line	:	SUITE A
City	:	LONG BEACH
State	:	CA
Zip	:	90806-2610
Country	:	US
Telephone Number	:	562-989-5722
Fax Number	:

Provider Business Practice Location Address
First Line	:	2683 PACIFIC AVE
Second Line	:	SUITE A
City	:	LONG BEACH
State	:	CA
Zip	:	90806-2610
Country	:	US
Telephone Number	:	562-989-5722
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/07/2008
Last Update Date	:	05/13/2015

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