Provider Demographics
NPI:1619372596
Name:MOROVATI, MARIA
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:MOROVATI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 HOLLYLEAF
Mailing Address - Street 2:
Mailing Address - City:ALISO VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92656-2129
Mailing Address - Country:US
Mailing Address - Phone:949-922-1553
Mailing Address - Fax:
Practice Address - Street 1:9 HOLLYLEAF
Practice Address - Street 2:
Practice Address - City:ALISO VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92656-2129
Practice Address - Country:US
Practice Address - Phone:949-922-1553
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-04
Last Update Date:2014-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA9011282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital