Individual provider · Type 1 NPI
Mary Jennifer Derebery
Otolaryngic Allergy Physician · Los Angeles, CA
NPI number
1457440992
Active
Practice location
2100 W 3rd St, Suite 111
Los Angeles, CA 90057-1944
Fax (213) 483-0905
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Otolaryngic Allergy Physician Primary | 207YX0602X | C42073 (CA) |
Otolaryngic Allergy Physician: An otolaryngologist who specializes in the diagnosis and treatment of otolaryngic allergies and other allergic diseases.
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About NPI 1457440992
Mary Jennifer Derebery's National Provider Identifier is 1457440992, issued on Oct 12, 2006. The primary taxonomy on file is Otolaryngic Allergy Physician (207YX0602X), and the practice location is in Los Angeles, CA. The record was last updated on Aug 15, 2013.