Healthcare Provider Details

I. General information

NPI: 1568636033
Provider Name (Legal Business Name): ASHLEY SLOANE MARGOL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ASHLEY SLOANE MARGOL MD

II. Dates (important events)

Enumeration Date: 04/16/2008
Last Update Date: 04/25/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1240 N MISSION RD L- 902
LOS ANGELES CA
90033-1019
US

IV. Provider business mailing address

1240 N MISSION RD L- 902
LOS ANGELES CA
90033-1019
US

V. Phone/Fax

Practice location:
  • Phone: 323-304-1777
  • Fax:
Mailing address:
  • Phone: 323-304-1777
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA103216
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: