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NPI Code Detail

MEDICARE: MARQUIS GODBEY IDC

MEDICARE:   MARQUIS  GODBEY  IDC
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
11710I1002XIndependent Duty CorpsmanCA

General Provider Information

NPI Number : 1598604654
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARQUIS GODBEY IDC
Provider Business Mailing Address
First Line : 34800 BOB WILSON DR
Second Line :
City : SAN DIEGO
State : CA
Zip : 92134-1098
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 34800 BOB WILSON DR
Second Line :
City : SAN DIEGO
State : CA
Zip : 92134-1098
Country : US
Telephone Number : 210-907-6872
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/25/2026
Last Update Date : 03/25/2026

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Directions to “ MARQUIS GODBEY IDC” Practice Location

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