Provider Demographics
NPI:1700142650
Name:ACIRO, MARILYN ALA-AN (MD)
Entity Type:Individual
Prefix:DR
First Name:MARILYN
Middle Name:ALA-AN
Last Name:ACIRO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:4085 HAWK ST
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92103-1831
Mailing Address - Country:US
Mailing Address - Phone:619-299-4330
Mailing Address - Fax:619-475-6204
Practice Address - Street 1:502 EUCLID AVE STE 201
Practice Address - Street 2:
Practice Address - City:NATIONAL CITY
Practice Address - State:CA
Practice Address - Zip Code:91950-2949
Practice Address - Country:US
Practice Address - Phone:619-475-6204
Practice Address - Fax:619-475-5174
Is Sole Proprietor?:No
Enumeration Date:2012-04-04
Last Update Date:2012-04-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA36352207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine