Provider Demographics
NPI:1154386290
Name:JANOSKI, MAURO C (MD)
Entity type:Individual
Prefix:DR
First Name:MAURO
Middle Name:C
Last Name:JANOSKI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:18000 STUDEBAKER RD STE 800
Mailing Address - Street 2:
Mailing Address - City:CERRITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90703-2671
Mailing Address - Country:US
Mailing Address - Phone:562-735-3226
Mailing Address - Fax:562-869-1281
Practice Address - Street 1:11480 BROOKSHIRE AVE.
Practice Address - Street 2:SUITE 309
Practice Address - City:DOWNEY
Practice Address - State:CA
Practice Address - Zip Code:90241-5025
Practice Address - Country:US
Practice Address - Phone:562-869-1201
Practice Address - Fax:562-869-1201
Is Sole Proprietor?:No
Enumeration Date:2006-04-20
Last Update Date:2024-06-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAC54846207RH0003X
WI84139207RH0003X
TN40198207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
G78605Medicare UPIN