Provider Demographics
NPI:1619232808
Name:MARILOU G CRUZ MD INC
Entity Type:Organization
Organization Name:MARILOU G CRUZ MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARILOU
Authorized Official - Middle Name:GEGARE
Authorized Official - Last Name:CRUZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:562-861-1245
Mailing Address - Street 1:8535 FLORENCE AVE STE 201
Mailing Address - Street 2:
Mailing Address - City:DOWNEY
Mailing Address - State:CA
Mailing Address - Zip Code:90240-4014
Mailing Address - Country:US
Mailing Address - Phone:562-861-1245
Mailing Address - Fax:562-904-1299
Practice Address - Street 1:9317 FIRESTONE BLVD
Practice Address - Street 2:
Practice Address - City:DOWNEY
Practice Address - State:CA
Practice Address - Zip Code:90241-5322
Practice Address - Country:US
Practice Address - Phone:562-861-1245
Practice Address - Fax:562-904-1299
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-12
Last Update Date:2023-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA44484261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care