Individual provider · Type 1 NPI

Mariah Ivory Cisneros

Student in an Organized Health Care Education/Training Program · Los Angeles, CA

NPI number 1538046412 Active

Practice location

942 S Atlantic Blvd
Los Angeles, CA 90022-4004

Call (323) 263-9700 Map

Fax (323) 263-8042

Mailing address

161 Bahia Dr
Covina, CA 91722-2862

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1538046412

Mariah Ivory Cisneros's National Provider Identifier is 1538046412, issued on Aug 20, 2025. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Los Angeles, CA. The record was last updated on Aug 20, 2025.