Individual
JOSEPH MARSHALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1530 BESSIE AVE, SUITE 108, TRACY, CA 95376-3080
(209) 833-2393
Mailing address
1530 BESSIE AVE, SUITE 108, TRACY, CA 95376-3080
(209) 833-2393
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
34673
IA
2085R0202X
Diagnostic Radiology Physician
Primary
G67457
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0264390
—
IA
01
—
290014639
RAILROAD MEDICARE
—
01
—
49423
BCBS OF IOWA
IA
Enumeration date
03/25/2006
Last updated
08/21/2014
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