Provider Demographics
NPI:1003144718
Name:OH, MARISA DANBEE (DO)
Entity Type:Individual
Prefix:DR
First Name:MARISA
Middle Name:DANBEE
Last Name:OH
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1107 W DUARTE RD
Mailing Address - Street 2:UNIT B
Mailing Address - City:ARCADIA
Mailing Address - State:CA
Mailing Address - Zip Code:91007-7769
Mailing Address - Country:US
Mailing Address - Phone:626-241-0704
Mailing Address - Fax:
Practice Address - Street 1:2020 ZONAL AVE
Practice Address - Street 2:LAC-USC MED CTR- INTERNS/RESIDENTS BUILDING, ROOM 112
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90089-0121
Practice Address - Country:US
Practice Address - Phone:626-241-0704
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-18
Last Update Date:2021-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A11041208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics