Provider Demographics
NPI:1902853419
Name:DOOST, MARY RC (MD)
Entity type:Individual
Prefix:DR
First Name:MARY
Middle Name:RC
Last Name:DOOST
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Gender:F
Credentials:MD
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Mailing Address - Street 1:2841 LOMITA BLVD
Mailing Address - Street 2:135
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505-5105
Mailing Address - Country:US
Mailing Address - Phone:310-784-6954
Mailing Address - Fax:310-326-5679
Practice Address - Street 1:2841 LOMITA BLVD
Practice Address - Street 2:135
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-5105
Practice Address - Country:US
Practice Address - Phone:310-784-6954
Practice Address - Fax:310-326-5679
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-28
Last Update Date:2013-02-06
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Provider Licenses
StateLicense IDTaxonomies
CAA75358207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA75358Medicare PIN