Most Relevant Information
Provider Data
| NPI Number: | 1003065020 |
| Provider Name: | ANA MARISELA MANCILLA |
| Entity Type: | Individual |
| Taxonomy Code: | 2355S0801X |
| Specialty: | Specialist/Technologist |
| License Number: | 876 |
Most Important Dates
| Enumeration Date: | 09/15/2008 |
| Last Updated: | 09/15/2008 |
Provider Practice Location
1530 S OLIVE ST
LOS ANGELES
CA
900153023
Practice Location Phone/Fax
| Phone: | 2137461037 |
| Fax: |
Provider Mailing Location
938 N BENTON WAY
LOS ANGELES
CA
900263826
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |