Provider Demographics
NPI:1922523943
Name:MAREENI T STANISLAUS MD A MEDICAL CORPORATION
Entity Type:Organization
Organization Name:MAREENI T STANISLAUS MD A MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MAREENI
Authorized Official - Middle Name:
Authorized Official - Last Name:STANISLAUS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:805-434-3000
Mailing Address - Street 1:350 POSADA LN STE 201
Mailing Address - Street 2:
Mailing Address - City:TEMPLETON
Mailing Address - State:CA
Mailing Address - Zip Code:93465-4060
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:350 POSADA LN STE 201
Practice Address - Street 2:
Practice Address - City:TEMPLETON
Practice Address - State:CA
Practice Address - Zip Code:93465-4060
Practice Address - Country:US
Practice Address - Phone:805-434-3000
Practice Address - Fax:805-329-5229
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-10
Last Update Date:2021-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty