DR. MARY JENNIFER DEREBERY


Address: 2100 W 3rd St, Suite 111, Los Angeles, CA 90057-1944
Phone: 2134839930

DR. MARY JENNIFER DEREBERY (NPI# 1457440992) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1457440992
Entity Type Individual
Full Name DR. MARY JENNIFER DEREBERY
Practice Address 2100 W 3rd St
Suite 111
Los Angeles
CA 90057-1944
Practice Telephone 2134839930
Practice Fax Number 2134830905
Mailing Telephone 2134839930
Mailing Fax Number 2134830905
Enumeration Date 2006-10-12
Last Update Date 2013-08-15
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207YX0602X Otolaryngology
Specialization: Otolaryngic Allergy
C42073 CA Allopathic & Osteopathic Physicians

Office Location

Street Address 2100 W 3RD ST
SUITE 111
City LOS ANGELES
State CA
Zip Code 90057-1944

Providers in the same location

NPI Name Taxonomy Address Enumeration
1114906013 Eric Peter Wilkinson Otolaryngology 2100 W 3rd St, #111, Los Angeles, CA 90057-1944 2006-01-10
1487188462 Ann Zhou Family Medicine 2100 W 3rd St, Los Angeles, CA 90057-1944 2017-04-17
1629442306 Hearing Health Centers LLC Audiologist-Hearing Aid Fitter 2100 W 3rd St, Suite 111, Los Angeles, CA 90057-1944 2015-11-18
1962800235 The Regents of The University of California Speech-Language Pathologist 2100 W 3rd St, 100, Los Angeles, CA 90057-1944 2014-12-18
1407122500 Tricia R Benjamin Audiologist 2100 W 3rd St, Los Angeles, CA 90057-1944 2012-03-22
1679861595 Denise Metalsky Audiologist 2100 W 3rd St, Suite 111, Los Angeles, CA 90057-1944 2011-07-12
1184931347 House Healthcare Inc. Otolaryngology 2100 W 3rd St, Suite 111, Los Angeles, CA 90057-1944 2010-09-09
1952620189 Gautam U Mehta Neurological Surgery 2100 W 3rd St, Los Angeles, CA 90057 2010-05-27
1730315425 Brian Shinrong Chen Otolaryngology 2100 W 3rd St, Suite 111, Los Angeles, CA 90057-1944 2009-06-08
1235303736 Erin Christine Mcalister Audiologist 2100 W 3rd St, Suite 111, Los Angeles, CA 90057-1944 2008-04-15
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
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1356818850 Anshim Acupuncture Inc Acupuncturist 4501 Alameda St., #107b #115, Los Angeles, CA 90057 2018-11-01
1538634670 Karina Herrera Case Manager/Care Coordinator 679 S. Hampshire Ave, Los Angeles, CA 90057 2018-10-04
1306323506 Jessica Myung Jin Yun Counselor 520 S Lafayette Park Pl, Unit 300, Los Angeles, CA 90057 2018-07-20
1851887012 Scott Moon Dentist 2426 W. 8th St. #209, Los Angeles, CA 90057 2018-07-10
1780176107 Bianca Zafiro Case Manager/Care Coordinator 672 S Lafayette Park Place, Suite 6, Los Angeles, CA 90057 2018-06-01
1639677438 Claudia E Vides Inc A Dental Corporation Clinic/Center 2033 W. 7th Street, Los Angeles, CA 90057 2018-01-26
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Taxonomy Information

Taxonomy Code 207YX0602X
Grouping Allopathic & Osteopathic Physicians
Classification Otolaryngology
Specialization Otolaryngic Allergy

Taxonomy Definition

An otolaryngologist who specializes in the diagnosis and treatment of otolaryngic allergies and other allergic diseases.
Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A Certification of Added Qualifications (CAQ) is issued by the American Osteopathic Board of Ophthalmology and Otolaryngology.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1932125044 Akira Ishiyama Otolaryngology 10833 Le Conte Ave, Los Angeles, CA 90095-0001 2006-07-14

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1326665415 Faculty Physicians and Surgeons of Llusm Otolaryngology 4646 Brockton Ave Ste 103, Riverside, CA 92506-0103 2020-07-06
1053705228 Beverly Hills Wellness Physicians Corp Otolaryngology 701 E 28th St Ste 100, Long Beach, CA 90806-2769 2015-03-25
1205181427 Walter Edwin Arute Otolaryngology 1945 Discovery Village Ln, Gold River, CA 95670-3063 2012-07-14
1750588257 Voice Institute of Beverly Hills A Medical Corporation Otolaryngology 8500 Wilshire Blvd Ste 908, Beverly Hills, CA 90211-3107 2007-06-28
1508916651 The Family-centered Ear, Nose, Throat Group Otolaryngology 18181 Butterfield Blvd Ste 180, Morgan Hill, CA 95037-8112 2007-01-11
1659394419 Quoc Ai Nguyen Otolaryngology 13362 Brookhurst St, Garden Grove, CA 92843-3153 2006-07-25
1164440822 Daniel Joseph Schlund Otolaryngology 125 Mall Dr, Ste 307, Hanford, CA 93230-5794 2006-07-18
1942244108 Donald Wilkes Burt Jr. Otolaryngology 18181 Butterfield Blvd Ste 120, Morgan Hill, CA 95037-8108 2006-06-16
1205804747 Darrell Herbert Hunsaker Otolaryngology 5121 San Aquario Dr, San Diego, CA 92109-1511 2006-03-10
1043212376 Ear Nose and Throat Medical Clinic Inc Otolaryngology 1050 Las Tablas Rd, Templeton, CA 93465-9729 2005-05-31
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Competitor

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City LOS ANGELES
Zip Code 90057

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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