Marie Mbouni M.D a Medical Corporation

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

C52701 Issued in CA

Legal business name

MARIE MBOUNI M.D A MEDICAL CORPORATION

Practice address

3751 Katella Ave
Los Alamitos, CA 90720-3101

Phone

(562) 799-3160

Fax

(562) 799-3133

NPI assigned

Sep 15, 2008

Last updated

Dec 30, 2008By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Marie T. Mbouni-Essomba, M.D

Title

President

Phone

(218) 233-3421

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1221436800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1230595200000",
    "number": "1548419518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 S 1ST ST",
            "address_2": "SUITE #1000",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915021938",
            "telephone_number": "818-845-6206",
            "fax_number": "818-845-9774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3751 KATELLA AVE",
            "city": "LOS ALAMITOS",
            "state": "CA",
            "postal_code": "907203101",
            "telephone_number": "562-799-3160",
            "fax_number": "562-799-3133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARIE MBOUNI M.D A MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-15",
        "last_updated": "2008-12-30",
        "status": "A",
        "authorized_official_last_name": "MBOUNI-ESSOMBA",
        "authorized_official_first_name": "MARIE",
        "authorized_official_middle_name": "T.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "218-233-3421",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "C52701",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "00C527010",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mark Ray Mallett, D.D.S
• Mamelita Inc. (Living Well Home Care)
• Angela Marie Mandas, MA
• Charles M Maples, D.O.
• Mariasol Pena MD
• Lisa Markouizos
• Paige Alexandra Marks, CADC I
• Zoe Martineau, BS, SLPA
• Stacey Martinelli
• Jared Austin Martinez

• Anesthesiology Physician in Los Alamitos, CA
• Providers in Los Alamitos, CA by specialty
• Anesthesiology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.