Individual
MARSHALL I. RAVDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6335 VIA MARIA, LA JOLLA, CA 92037-6543
(858) 405-7197
Mailing address
6335 VIA MARIA, LA JOLLA, CA 92037-6543
(858) 405-7197
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
C42864
CA
Other
Enumeration date
11/29/2006
Last updated
06/10/2014
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