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General NPI Number Information
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NPI Number | 1124293170
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Entity Type | Organization
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Legal Business Name | MARTA L CHEATHAM LOTT M D INC
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Dates
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Enumeration Date | 04/29/2008
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Last Update Date | 02/23/2011
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Provider Practice Location Address
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Address Line | 355 TERRACINA BLVD SUITE A
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City | REDLANDS
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State | CA
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Zip | 92373-4819
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Country | US
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Telephone | 909-792-1111
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Fax | 909-792-7772
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Provider Business Mailing Address
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Address Line | PO BOX 446
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City | BANNING
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State | CA
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Zip | 92220-0016
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Country | US
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Telephone | 909-792-1111
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Fax | 909-792-7772
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Authorized Official
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Title or Position | OBSTETRICIAN/GYNECOLOGIST
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Name | DR. MARTA LALITH CHEATHAM-LOTT
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Credential | M.D.
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Telephone | 909-792-1111
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number |
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License Number State |
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