Individual
DR. MARJORIE Y ODA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1 DANIEL BURNHAM COURT, SUITE 365C, SAN FRANCSICO, CA 94109
(415) 202-1920
(415) 922-6344
Mailing address
611 LA MESA DRIVE, PORTOLA VALLEY, CA 94028
(650) 854-2831
(415) 922-6344
Taxonomy
Speciality
Code
Description
License number
State
173000000X
Legal Medicine
Primary
G30402
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
913552
QME CERTIFICATE
CA
01
—
G30402
CA LICENSE
CA
Enumeration date
10/04/2006
Last updated
03/07/2023
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