Search › California › 363A00000X
Mara Kamyl Custodio, PA-C
NPI 1932729829 · on the registry since 2020 · sole proprietor
Practice
- Address
- 9300 Campus Point Dr
La Jolla, CA 92037 - Phone
- (800) 926-8273
- Organisation at this address
- Ucsd Medical Center
Regents Of The University Of California
Regents Of The Unviersity Of California
University Of California, San Diego Medical CenterInferred from a shared address, not stated in the registry. - Clinicians at this address
- 373
Additional practice sites
- 910 Vine St, Los Angeles, CA
- 4303 La Jolla Village Dr, San Diego, CA
- 200 W Arbor Dr, San Diego, CA
Registry record
- Primary taxonomy
- 363A00000X
363A00000X
- Also registered as
- 390200000X
- Licence states on file
- CA
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2025-01-27
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in California