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NPI Code Detail

MEDICARE: MARY MICHELE LIMBO CORPUZ M.D.

MEDICARE: MARY MICHELE LIMBO CORPUZ 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
1208000000XPediatrics PhysicianA119090CA

General Provider Information

NPI Number : 1770808719
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARY MICHELE LIMBO CORPUZ M.D.
Provider Business Mailing Address
First Line : 757 WESTWOOD PLZ
Second Line : B711 RRUMC
City : LOS ANGELES
State : CA
Zip : 90095-7419
Country : US
Telephone Number : 310-267-9128
Fax Number :
Provider Business Practice Location Address
First Line : 757 WESTWOOD PLZ
Second Line : B711 RRUMC
City : LOS ANGELES
State : CA
Zip : 90095-7419
Country : US
Telephone Number : 310-267-9128
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/01/2010
Last Update Date : 08/22/2025

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