Mary J Derebery (NPI# 1457440992, PAC ID# 7012990708) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is OTOLARYNGOLOGY.
| Nation Provider ID (NPI) | 1457440992 |
| PAC ID by PECOS | 7012990708 |
| Professional Enrollment ID | I20110628000777 |
| Full Name | Mary J Derebery |
| Organization Legal Name | HOUSE EAR CLINIC INC |
| Address |
2100 W 3rd St Suite 111 Los Angeles CA 90057-1999 |
| Phone Number | 2134839930 |
| Gender | F |
| Medical School | MEMPHIS HOSPITAL MEDICAL COLLEGE |
| Graduation Year | 1979 |
| Primary Specialty | OTOLARYNGOLOGY |
| Group Practice PAC ID | 1759364441 |
| Number of Group Practice Members | 21 |
| Accepts Medicare Assignment | Y |
| Address | Phone | Organization |
|---|---|---|
| 2100 W 3rd St, Suite 111, Los Angeles, CA 90057-1999 | 2134839930 | HOUSE EAR CLINIC INC |
| Organization Legal Name | HOUSE EAR CLINIC INC |
| Physicians | 26 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Samantha Coppa | Audiologist | House Ear Clinic Inc | 2100 W 3rd St 1st Floor, Los Angeles, CA 90057-1902 |
| Eric P Wilkinson | Otolaryngology | House Ear Clinic Inc | 2100 W 3rd St, Suite 111, Los Angeles, CA 90057-1999 |
| Sherry S Young | Qualified Audiologist | House Ear Clinic Inc | 2100 W 3rd St, Suite 111, Los Angeles, CA 90057-1999 |
| Stephani M Rose | Qualified Audiologist | House Ear Clinic Inc | 431 S Batavia St, Suite 200, Orange, CA 92868-3937 |
| William H Slattery Iii | Otolaryngology | House Ear Clinic Inc | 2100 W 3rd St, Suite 111, Los Angeles, CA 90057-1999 |
| Kevin A Peng | Otolaryngology | House Ear Clinic Inc | 2100 W 3rd St, Suite 111, Los Angeles, CA 90057-1999 |
| Wadad Shalhub | Qualified Audiologist | House Ear Clinic Inc | 2100 W 3rd St, Suite 111, Los Angeles, CA 90057-1999 |
| Soo J Jang | Qualified Audiologist | House Ear Clinic Inc | 2100 W 3rd St, Suite 111, Los Angeles, CA 90057-1999 |
| John House | Otolaryngology | House Ear Clinic Inc | 2100 W 3rd St, Suite 111, Los Angeles, CA 90057-1999 |
| Edward I Cho | Otolaryngology | House Ear Clinic Inc | 2100 W 3rd St, Suite 111, Los Angeles, CA 90057-1999 |
| Street Address |
2100 W 3RD ST SUITE 111 |
| City | LOS ANGELES |
| State | CA |
| Zip | 90057-1999 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Eric P Wilkinson | Otolaryngology | House Ear Clinic Inc | 2100 W 3rd St, Suite 111, Los Angeles, CA 90057-1999 |
| Sherry S Young | Qualified Audiologist | House Ear Clinic Inc | 2100 W 3rd St, Suite 111, Los Angeles, CA 90057-1999 |
| William H Slattery Iii | Otolaryngology | House Ear Clinic Inc | 2100 W 3rd St, Suite 111, Los Angeles, CA 90057-1999 |
| Kevin A Peng | Otolaryngology | House Ear Clinic Inc | 2100 W 3rd St, Suite 111, Los Angeles, CA 90057-1999 |
| Wadad Shalhub | Qualified Audiologist | House Ear Clinic Inc | 2100 W 3rd St, Suite 111, Los Angeles, CA 90057-1999 |
| Soo J Jang | Qualified Audiologist | House Ear Clinic Inc | 2100 W 3rd St, Suite 111, Los Angeles, CA 90057-1999 |
| Monica Rae Eschagary | Qualified Audiologist | The Regents of The University of California | 2100 W 3rd St, Suite 100, Los Angeles, CA 90057-1971 |
| John House | Otolaryngology | House Ear Clinic Inc | 2100 W 3rd St, Suite 111, Los Angeles, CA 90057-1999 |
| Edward I Cho | Otolaryngology | House Ear Clinic Inc | 2100 W 3rd St, Suite 111, Los Angeles, CA 90057-1999 |
| Derald E Brackmann | Otolaryngology | House Ear Clinic Inc | 2100 W 3rd St, Suite 111, Los Angeles, CA 90057-1999 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Margarita S Symonian Silver | Nephrology | St Vincent Medical Ctr, 2131 W 3rd Street, Los Angeles, CA 90057-0992 | |
| Juan Carlos Echeverria | Diagnostic Radiology | Radadvantage A Professional Corporation | 2131 W 3rd St, Los Angeles, CA 90057-1901 |
| Shahram S Farahvash | Anesthesiology | St. Vincent Anesthesia Medical Group Inc | 2131 W 3rd St, Los Angeles, CA 90057-1901 |
| Raymond D Gritton | Physical Medicine and Rehabilitation | 2131 W 3rd St, Los Angeles, CA 90057-1901 | |
| Ram K Sharma | Anesthesiology | Axiom Anesthesia Group Inc | 2131 W 3rd St, Los Angeles, CA 90057-1901 |
| Carmela Yomtoubian | Emergency Medicine | Cep America - California | 2131 W 3rd St, Los Angeles, CA 90057-1901 |
| Julio A Raya | Anesthesiology | Axiom Anesthesia Group Inc | 2131 W 3rd St, Los Angeles, CA 90057-1901 |
| Andrew M Abdelmalek | Anesthesiology | Axiom Anesthesia Group Inc | 2131 W 3rd St, Los Angeles, CA 90057-1901 |
| Ralph Cabrera | Certified Registered Nurse Anesthetist (crna) | St. Vincent Anesthesia Medical Group Inc | 2131 W 3rd St, Los Angeles, CA 90057-1901 |
| Grace Lin | Nephrology | Gch Medical Group Inc | 2131 W 3rd St, Los Angeles, CA 90057-1901 |
| Find all physicians in zip 90057 | |||
| City | LOS ANGELES |
| Zip Code | 90057 |
| Specialty | OTOLARYNGOLOGY |
| City + Specialty | LOS ANGELES + OTOLARYNGOLOGY |
Please comment or provide details below to improve the information on Mary J Derebery.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.