Organization
GARY B. MARCUS, M.D. - A PROFESSIONAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ESTELLA M OLSEN (ADMINISTRATOR)
(510) 734-0677
Entity
Organization
Contact information
Practice address
1430 TARA HILLS DR, SUITE A, PINOLE, CA 94564-2580
(510) 640-0019
(510) 640-0021
Mailing address
1430 TARA HILLS DR, SUITE A, PINOLE, CA 94564-2580
(510) 640-0019
(510) 640-0021
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
C28611
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1073526646
INDIVIDUAL NPI FOR GARY MARCUS, M.D.
CA
Enumeration date
01/08/2016
Last updated
02/04/2016
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