Provider Demographics
NPI:1962643163
Name:MACIAS, ANA MARIA (NP)
Entity type:Individual
Prefix:MRS
First Name:ANA MARIA
Middle Name:
Last Name:MACIAS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MRS
Other - First Name:ANA MARIA
Other - Middle Name:
Other - Last Name:SILVA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:19191 S VERMONT AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90502-1049
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1025 W OLYMPIC BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90015-1329
Practice Address - Country:US
Practice Address - Phone:213-623-2225
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-03-18
Last Update Date:2009-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA572367363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily