Individual
MRS. MICAELA MARIN-TUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
12677 HESPERIA RD, SUITE 160, VICTORVILLE, CA 92395-7735
(760) 955-5656
(760) 955-6176
Mailing address
12677 HESPERIA RD, SUITE 160, VICTORVILLE, CA 92395-7735
(760) 955-5656
(760) 955-6176
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA15871
CA
Other
Enumeration date
08/07/2009
Last updated
08/07/2009
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