Healthcare Provider Details

I. General information

NPI: 1235101874
Provider Name (Legal Business Name): MARIA C DUNGO M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/07/2006
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11800 WILSHIRE BLVD
LOS ANGELES CA
90025-6602
US

IV. Provider business mailing address

4140 W 190TH ST FL 2
TORRANCE CA
90504-5513
US

V. Phone/Fax

Practice location:
  • Phone: 310-231-2121
  • Fax:
Mailing address:
  • Phone: 310-231-2121
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License NumberA66606
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: