Provider Demographics
NPI:1710324512
Name:MURRY, WHATANA
Entity Type:Individual
Prefix:
First Name:WHATANA
Middle Name:
Last Name:MURRY
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 1:11705 DEPUTY YAMAMOTO PL
Mailing Address - Street 2:
Mailing Address - City:LYNWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90262-4031
Mailing Address - Country:US
Mailing Address - Phone:323-357-6930
Mailing Address - Fax:
Practice Address - Street 1:11705 DEPUTY YAMAMOTO PL
Practice Address - Street 2:
Practice Address - City:LYNWOOD
Practice Address - State:CA
Practice Address - Zip Code:90262-4031
Practice Address - Country:US
Practice Address - Phone:323-357-6930
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-03
Last Update Date:2013-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist