MEDICARE: MRS. JOANNE M MARCUS PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	PA18562	CA

General Provider Information

NPI Number	:	1356507420
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JOANNE M MARCUS PA

Provider Business Mailing Address
First Line	:	2490 HOSPITAL DR
Second Line	:	STE 211
City	:	MOUNTAIN VIEW
State	:	CA
Zip	:	94040-4125
Country	:	US
Telephone Number	:	408-245-4048
Fax Number	:	408-245-6131

Provider Business Practice Location Address
First Line	:	500 E REMINGTON DR STE 20
Second Line	:
City	:	SUNNYVALE
State	:	CA
Zip	:	94087-2612
Country	:	US
Telephone Number	:	408-245-4048
Fax Number	:	408-245-6131

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/29/2008
Last Update Date	:	01/12/2018

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