Provider Demographics
NPI:1821046301
Name:PONCE, MARIA C (MD)
Entity Type:Individual
Prefix:DR
First Name:MARIA
Middle Name:C
Last Name:PONCE
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:1307 W. 6TH STREET
Mailing Address - Street 2:SUITE 113
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92882-3168
Mailing Address - Country:US
Mailing Address - Phone:951-278-8910
Mailing Address - Fax:951-734-6022
Practice Address - Street 1:2208 W 7TH ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90057-4002
Practice Address - Country:US
Practice Address - Phone:213-637-2530
Practice Address - Fax:213-384-3373
Is Sole Proprietor?:No
Enumeration Date:2006-05-05
Last Update Date:2012-05-31
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA85618207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A856180Medicaid
CA00A856180Medicaid
CAI02326Medicare UPIN