Provider Demographics
NPI:1255696068
Name:MAITOZA, LAURA ANNE (MD)
Entity type:Individual
Prefix:DR
First Name:LAURA
Middle Name:ANNE
Last Name:MAITOZA
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Gender:F
Credentials:MD
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Mailing Address - Street 1:5767 W CENTURY BLVD STE 400
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90045-5631
Mailing Address - Country:US
Mailing Address - Phone:310-301-8707
Mailing Address - Fax:310-301-8751
Practice Address - Street 1:200 UCLA MEDICAL PLZ STE 265
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90095-0001
Practice Address - Country:US
Practice Address - Phone:310-825-0867
Practice Address - Fax:310-206-4855
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-08
Last Update Date:2021-06-29
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Provider Licenses
StateLicense IDTaxonomies
CAA1266742080P0203X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes2080P0203XAllopathic & Osteopathic PhysiciansPediatricsPediatric Critical Care Medicine