| Luis Mario Marquez M D Inc | |
|
4060 Fourth Ave Ste 540 San Diego CA 92103-2121 | |
| (619) 236-8796 | |
| (619) 238-5702 |
| Full Name | Luis Mario Marquez M D Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 4060 Fourth Ave Ste 540, San Diego, California |
| Authorized Official Name and Position | Fiona Dempsey (ADMINISTRATOR) |
| Authorized Official Contact | 8582707633 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Luis Mario Marquez M D Inc 4060 Fourth Ave Ste 540 San Diego CA 92103-2121 Ph: (619) 236-8796 | Luis Mario Marquez M D Inc 4060 Fourth Ave Ste 540 San Diego CA 92103-2121 Ph: (619) 236-8796 |
| NPI Number | 1427110790 |
|---|---|
| Provider Enumeration Date | 12/14/2006 |
| Last Update Date | 10/14/2024 |
| Medicare PECOS PAC ID | 5991897332 |
|---|---|
| Medicare Enrollment ID | O20070815000530 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427110790 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | A45934 (California) | Primary |
| Provider Name | Luis M Marquez |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1801865795 PECOS PAC ID: 7214924299 Enrollment ID: I20040429001598 |
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