Healthcare Provider Details

I. General information

NPI: 1427454586
Provider Name (Legal Business Name): MARIA UBARIO I
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/17/2014
Last Update Date: 10/11/2023
Certification Date: 10/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2121 W TEMPLE ST STE 104
LOS ANGELES CA
90026-4915
US

IV. Provider business mailing address

2121 W TEMPLE ST STE 104
LOS ANGELES CA
90026-4915
US

V. Phone/Fax

Practice location:
  • Phone: 323-385-5100
  • Fax:
Mailing address:
  • Phone: 323-385-5100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License NumberMPSS-OZHDXP
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: