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General NPI Number Information
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NPI Number | 1073756557
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Entity Type | Organization
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Legal Business Name | CORNELIA B. ODELL, M.D.,INC
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Dates
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Enumeration Date | 04/13/2009
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Last Update Date | 04/13/2009
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Provider Practice Location Address
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Address Line | 675 S ARROYO PKWY SUITE# 410
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City | PASADENA
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State | CA
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Zip | 91105-3263
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Country | US
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Telephone | 626-405-1035
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Fax | 626-405-1036
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Provider Business Mailing Address
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Address Line | PO BOX 50687
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City | PASADENA
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State | CA
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Zip | 91115-0687
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Country | US
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Telephone | 626-405-1035
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Fax | 626-405-1036
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Authorized Official
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Title or Position | DIRECTOR OF BILLING OPERATIONS
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Name | MARINA RIVERA
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Credential |
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Telephone | 626-757-2269
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | A76154
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License Number State | CA
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