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Individual

MARLENE GRENON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
400 PARNASSUS AVE, SUITE A 581, SAN FRANCISCO, CA 94143-2202
(415) 353-2357
Mailing address
400 PARNASSUS AVE, SUITE A 581, SAN FRANCISCO, CA 94143-2202

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
41320
AZ
2086S0129X
Vascular Surgery Physician
41320
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
860338466
TAX-ID
AZ
Enumeration date
03/31/2009
Last updated
02/10/2010
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