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Individual

MARCUS MACHADO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
166 LANG ST, SAN JUAN BAUTISTA, CA 95045-9401
(408) 390-0094
Mailing address
166 LANG ST, SAN JUAN BAUTISTA, CA 95045-9401
(408) 390-0094

Taxonomy

Speciality
Code
Description
License number
State
172A00000X
Driver
Primary

Other

Enumeration date
10/09/2015
Last updated
10/09/2015
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  • EDI platform