Individual
DR. MARIE ANSON-REBONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2350 MCKEE ROAD, STE 1, SAN JOSE, CA 95116-1606
(408) 729-3232
(408) 729-2165
Mailing address
2350 MCKEE ROAD, STE 1, SAN JOSE, CA 95116-1606
(408) 729-3232
(408) 729-2165
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
A45814
CA
208D00000X
General Practice Physician
A45814
CA
Other
Enumeration date
08/01/2006
Last updated
10/30/2014
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