Provider Demographics
NPI:1831131424
Name:DE ALDAY, MARIETTA YUMENA (MD)
Entity Type:Individual
Prefix:
First Name:MARIETTA
Middle Name:YUMENA
Last Name:DE ALDAY
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Gender:F
Credentials:MD
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Mailing Address - Street 1:ONE GOLDEN SHORE
Mailing Address - Street 2:MOLINA MEDICAL CENTERS SMO
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90802-4202
Mailing Address - Country:US
Mailing Address - Phone:661-723-3874
Mailing Address - Fax:661-723-9975
Practice Address - Street 1:44256 N 10TH STREET
Practice Address - Street 2:MOLINA MEDICAL CENTER
Practice Address - City:W LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93534-4134
Practice Address - Country:US
Practice Address - Phone:661-723-3874
Practice Address - Fax:661-723-9975
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-11
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
CAA53001208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
G12971Medicare UPIN