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Individual

MARCUS IAN PENCE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
1500 SAN PABLO ST, LOS ANGELES, CA 90033-5313
(323) 442-7400
Mailing address
PO BOX 31309, LOS ANGELES, CA 90031-0309
(323) 442-7400

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
815746
CA
367500000X
Certified Registered Nurse Anesthetist
Primary
NA95001552
CA

Other

Enumeration date
05/04/2021
Last updated
12/08/2021
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