Individual
SERGIO MARQUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1338 HOLM AVE, MODESTO, CA 95351-4704
(209) 408-4140
Mailing address
1338 HOLM AVE, MODESTO, CA 95351-4704
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
11/21/2016
Last updated
11/21/2016
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