Provider Demographics
NPI:1700829934
Name:MARFISEE, MARY M (MD)
Entity Type:Individual
Prefix:DR
First Name:MARY
Middle Name:M
Last Name:MARFISEE
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:5767 W CENTURY BLVD
Mailing Address - Street 2:STE 200
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90045-5632
Mailing Address - Country:US
Mailing Address - Phone:310-301-8708
Mailing Address - Fax:310-206-8237
Practice Address - Street 1:545 S SAN PEDRO ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90013-2101
Practice Address - Country:US
Practice Address - Phone:213-673-4849
Practice Address - Fax:310-206-8237
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2015-03-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA88225207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A882250Medicaid
CA00A882250Medicaid