Organization
MARSHALL MEDICAL CENTER
Active
Other names
Marshall ENT, Marshall ENT
Organization subpart
No
Provider details
NPI number
Authorized official
SIRI NELSON (CEO)
(530) 622-1441
Entity
Organization
Contact information
Practice address
4300 GOLDEN CENTER DR, SUITE D, PLACERVILLE, CA 95667-6278
(530) 344-2000
(530) 344-2014
Mailing address
PO BOX 45680, SAN FRANCISCO, CA 94145-0680
(530) 626-2787
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
—
—
207YX0905X
Otolaryngology/Facial Plastic Surgery Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ZZZ03776Z
MEDICARE PTAN
CA
Enumeration date
10/05/2010
Last updated
03/09/2026
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