Provider Demographics
NPI:1154793628
Name:MARIANNE M. CUTTIC, DPM, INC
Entity type:Organization
Organization Name:MARIANNE M. CUTTIC, DPM, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARRIANNE
Authorized Official - Middle Name:M
Authorized Official - Last Name:CUTTIC
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:310-316-7020
Mailing Address - Street 1:1970 S PROSPECT AVENUE
Mailing Address - Street 2:SUITE 4
Mailing Address - City:REDONDO BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90277
Mailing Address - Country:US
Mailing Address - Phone:310-316-7020
Mailing Address - Fax:310-316-7411
Practice Address - Street 1:1970 S PROSPECT AVENUE
Practice Address - Street 2:SUITE 4
Practice Address - City:REDONDO BEACH
Practice Address - State:CA
Practice Address - Zip Code:90277
Practice Address - Country:US
Practice Address - Phone:310-316-7020
Practice Address - Fax:310-316-7411
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-23
Last Update Date:2015-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty