Healthcare Provider Details

I. General information

NPI: 1114037645
Provider Name (Legal Business Name): MARY DOYLE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MARY DOYLE M.D.

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 08/29/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9320 TELSTAR AVE SUITE 226
EL MONTE CA
91731-2834
US

IV. Provider business mailing address

9320 TELSTAR AVENUE SUITE 226, ROOM 246
EL MONTE CA
91731
US

V. Phone/Fax

Practice location:
  • Phone: 626-569-6484
  • Fax:
Mailing address:
  • Phone: 626-569-6484
  • Fax: 626-569-9346

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberG56282
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: