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1104408442
MARINA BASTA
TARZANA, CA
NPI
1104408442
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2021-04-26
Last Update Date
2021-04-26
Business Address
MARINA BASTA Student
18646 OXNARD ST
TARZANA, CA 91356-1411
Phone number: 818-654-3908
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Mailing Address
MARINA BASTA Student
25922 SPENCER CT
CALABASAS, CA 91302-3167
Phone number: 818-917-7131
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