Most Relevant Information
Provider Data
| NPI Number: | 1003513557 |
| Provider Name: | MARISSA LEE LUBAG |
| Entity Type: | Individual |
| Taxonomy Code: | 171M00000X |
| Specialty: | Case Manager/Care Coordinator |
| License Number: |
Most Important Dates
| Enumeration Date: | 02/14/2023 |
| Last Updated: | 09/19/2023 |
Provider Practice Location
1774 ZONAL AVE BLDG C
LOS ANGELES
CA
900331064
Practice Location Phone/Fax
| Phone: | 3102216336 |
| Fax: |
Provider Mailing Location
1774 ZONAL AVE BLDG C
LOS ANGELES
CA
900331064
Provider Mailing Phone/Fax
| Phone: | 3102216336 |
| Fax: |