Individual
MARCIA ANN LUISI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
990 SONOMA AVE, SUITE #3, SANTA ROSA, CA 95404-4802
(707) 546-5487
(707) 546-5488
Mailing address
990 SONOMA AVE, SUITE #3, SANTA ROSA, CA 95404-4802
(707) 546-5487
(707) 546-5488
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
G61709
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G617090
—
CA
Enumeration date
10/09/2006
Last updated
07/08/2007
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