Provider Demographics
NPI:1699976589
Name:UMINSKI, MARCIA L (CRNA)
Entity type:Individual
Prefix:
First Name:MARCIA
Middle Name:L
Last Name:UMINSKI
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:MARCIA
Other - Middle Name:L
Other - Last Name:UMINSKI-WEISSMAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:25825 S. VERMONT AVE.
Mailing Address - Street 2:
Mailing Address - City:HARBOR CITY
Mailing Address - State:CA
Mailing Address - Zip Code:90710
Mailing Address - Country:US
Mailing Address - Phone:310-257-2585
Mailing Address - Fax:310-257-6699
Practice Address - Street 1:25825 VERMONT AVE
Practice Address - Street 2:
Practice Address - City:HARBOR CITY
Practice Address - State:CA
Practice Address - Zip Code:90710-3518
Practice Address - Country:US
Practice Address - Phone:310-257-2585
Practice Address - Fax:310-257-6699
Is Sole Proprietor?:No
Enumeration Date:2007-05-30
Last Update Date:2013-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANA1003367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered