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Marina Women'S Medical Group, INC.

Obstetrics & Gynecology in Marina Del Rey, CA. Organization (NPI-2).

NPI number1104846682
StatusActive
Last updated in NPPESJul 13, 2010

Details

NPI
1104846682
Entity type
Organization (NPI-2)
Legal business name
Marina Women'S Medical Group, INC.
Organization subpart
No
Enumeration date
Jul 20, 2006
Last updated
Jul 13, 2010

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207V00000X Obstetrics & GynecologyC35271CAYes

Practice location

4560 Admiralty Way
303
Marina Del Rey, CA 90292-5423

Phone 310-822-5066 · Fax 310-827-4420

Mailing address

4560 Admiralty Way
303
Marina Del Rey, CA 90292-5423

Phone 310-822-5066 · Fax 310-827-4420

Authorized official

Dale Gene Parks
MD/Owner
3108225066

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