Individual
VIVIAN M MARCUZZO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
2730 S VAL VISTA DR, SUITE 187, GILBERT, AZ 85295-1675
(480) 324-0300
(480) 324-0324
Mailing address
6112 E BROWN RD, MESA, AZ 85205-4955
(480) 448-0244
(480) 924-4140
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA17936
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00281443
RAILROAD MEDICARE
—
05
—
PA17938
—
CA
Enumeration date
08/21/2006
Last updated
01/07/2021
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