Provider Demographics
NPI:1689660458
Name:PARIEWSKI, MARTA ELENA (MD)
Entity type:Individual
Prefix:DR
First Name:MARTA
Middle Name:ELENA
Last Name:PARIEWSKI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9911 W PICO BLVD
Mailing Address - Street 2:SUITE 1260
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90035
Mailing Address - Country:US
Mailing Address - Phone:310-557-2405
Mailing Address - Fax:310-557-9657
Practice Address - Street 1:9911 W PICO BLVD
Practice Address - Street 2:SUITE 1260
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90035
Practice Address - Country:US
Practice Address - Phone:310-557-2405
Practice Address - Fax:310-557-9657
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA264292084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA26429Medicaid
B50034Medicare UPIN
CAA26429Medicaid