Healthcare Provider Details

I. General information

NPI: 1720944648
Provider Name (Legal Business Name): MRS. MARANATHA SIEGMUND BATTUNG
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/05/2026
Last Update Date: 01/05/2026
Certification Date: 01/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1703 E HOLLY AVE
EL SEGUNDO CA
90245-4405
US

IV. Provider business mailing address

604 W 103RD ST
LOS ANGELES CA
90044-4540
US

V. Phone/Fax

Practice location:
  • Phone: 504-330-7532
  • Fax:
Mailing address:
  • Phone: 504-330-7532
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174N00000X
TaxonomyLactation Consultant (Non-RN)
License Number
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: