Healthcare Provider Details

I. General information

NPI: 1609200518
Provider Name (Legal Business Name): MARIANNE CADIZ NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/27/2013
Last Update Date: 08/27/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6000 N FIGUEROA ST
LOS ANGELES CA
90042-4232
US

IV. Provider business mailing address

6000 N FIGUEROA ST
LOS ANGELES CA
90042-4232
US

V. Phone/Fax

Practice location:
  • Phone: 323-254-5291
  • Fax: 323-254-4618
Mailing address:
  • Phone: 323-254-5291
  • Fax: 323-254-4618

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number23373
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: