Provider Demographics
NPI:1518773704
Name:MAZARIEGOS, INMARI A I
Entity type:Individual
Prefix:
First Name:INMARI
Middle Name:A
Last Name:MAZARIEGOS
Suffix:I
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12107 OKLAHOMA AVE
Mailing Address - Street 2:
Mailing Address - City:SOUTH GATE
Mailing Address - State:CA
Mailing Address - Zip Code:90280-8008
Mailing Address - Country:US
Mailing Address - Phone:213-804-8099
Mailing Address - Fax:
Practice Address - Street 1:12107 OKLAHOMA AVE
Practice Address - Street 2:
Practice Address - City:SOUTH GATE
Practice Address - State:CA
Practice Address - Zip Code:90280-8008
Practice Address - Country:US
Practice Address - Phone:213-804-8099
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-04
Last Update Date:2024-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula