Individual
DR. DERRICK V MARINELLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
G59971
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05D0552498
CLIA
CA
01
—
05D0684380
CLIA
CA
01
—
05D0977537
CLIA
—
01
—
1851498133
GROUP NPI
CA
01
—
G59971
PHYS LICENSE
CA
01
—
GR0011581
MEDI CAL GROUP
CA
01
—
YYY49655Y
BLUE SHIELD
CA
Enumeration date
04/10/2007
Last updated
12/01/2021
Update your record
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