Provider Demographics
NPI:1124293170
Name:MARTA L CHEATHAM LOTT M D INC
Entity type:Organization
Organization Name:MARTA L CHEATHAM LOTT M D INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OBSTETRICIAN/GYNECOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MARTA
Authorized Official - Middle Name:LALITH
Authorized Official - Last Name:CHEATHAM-LOTT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:909-792-1111
Mailing Address - Street 1:PO BOX 446
Mailing Address - Street 2:
Mailing Address - City:BANNING
Mailing Address - State:CA
Mailing Address - Zip Code:92220-0016
Mailing Address - Country:US
Mailing Address - Phone:909-792-1111
Mailing Address - Fax:909-792-7772
Practice Address - Street 1:355 TERRACINA BLVD
Practice Address - Street 2:SUITE A
Practice Address - City:REDLANDS
Practice Address - State:CA
Practice Address - Zip Code:92373-4819
Practice Address - Country:US
Practice Address - Phone:909-792-1111
Practice Address - Fax:909-792-7772
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-29
Last Update Date:2011-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty