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Individual

MINDY LISA MARQUEZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
3250 BEARD RD, NAPA, CA 94558-3406
(707) 224-7944
(707) 224-5220
Mailing address
2637 SHADELANDS DR, WALNUT CREEK, CA 94598-2512
(925) 948-8143

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
A106559
CA
208800000X
Urology Physician
MD00045739
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0209119
LABOR AND INDUSTRY
WA
05
8453318
WA
01
MD00045739
STATE LICENSE NUMBER
WA
01
P00340057
RAILROAD MEDICARE
WA
Enumeration date
06/05/2006
Last updated
09/15/2017
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