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NPI Code Detail

MEDICARE: ANNA MARIE KORDA

MEDICARE:   ANNA MARIE KORDA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1122300000XDentist26665CA

General Provider Information

NPI Number : 1396047635
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANNA MARIE KORDA
Provider Business Mailing Address
First Line : 3666 INGLEWOOD BLVD
Second Line :
City : LOS ANGELES
State : CA
Zip : 90066-2828
Country : US
Telephone Number : 310-836-3476
Fax Number :
Provider Business Practice Location Address
First Line : 3666 INGLEWOOD BLVD
Second Line :
City : LOS ANGELES
State : CA
Zip : 90066-2828
Country : US
Telephone Number : 310-836-3476
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/18/2010
Last Update Date : 11/18/2010

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Directions to “ ANNA MARIE KORDA ” Practice Location

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