Individual
MARCUS LYNN BRIGGS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
16851 EAGLE PEAK RD, RIVERSIDE, CA 92504-8808
(951) 789-2914
Mailing address
16851 EAGLE PEAK RD, RIVERSIDE, CA 92504-8808
(951) 789-2914
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
45400
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
MEDICAID
—
CA
Enumeration date
07/10/2015
Last updated
07/10/2015
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