Modirrousta, Maryam

Modirrousta, Maryam is an individual health care provider with primary practice located at 18300 Us Highway 18 , Apple Valley CA 92307-2206. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife, which is considered as her primary health care specialty. Modirrousta, Maryam can be contacted via phone (706) 242-2311.

Contact Information

Primary practice address
18300 Us Highway 18 Apple Valley CA 92307-2206
Phone: (706) 242-2311
Fax: (760) 946-8875
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife 367A00000X NMW1949 California

Profile Details

NPI number 1548514565
LBN Legal business name Modirrousta, Maryam
Credentials CNM, NP
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 29th, 2012
Last updated Dec 8th, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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