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NPI Code Detail

MEDICARE: MARY LOU OZOHAN MD

MEDICARE: MARY LOU OZOHAN MD
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
1174400000XSpecialistA23566CA
22085R0001XRadiation Oncology PhysicianA23566CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1609859412
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARY LOU OZOHAN MD
Provider Business Mailing Address
First Line : PO BOX 513969
Second Line :
City : LOS ANGELES
State : CA
Zip : 90051-3969
Country : US
Telephone Number : 310-335-4065
Fax Number : 310-335-4098
Provider Business Practice Location Address
First Line : 5522 SEPULVEDA BLVD
Second Line :
City : SHERMAN OAKS
State : CA
Zip : 91411-3437
Country : US
Telephone Number : 818-997-1522
Fax Number : 818-997-0705
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/25/2005
Last Update Date : 06/01/2015

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Directions to “ MARY LOU OZOHAN MD” Practice Location

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