MEDICARE: DR. ANNE L MARANGONI D.P.M.

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	213E00000X	Podiatrist	E3219	CA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	BBB31601B	OTHER	CA	MEDICARE SUBMITTER NUMBER

General Provider Information

NPI Number	:	1609933738
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANNE L MARANGONI D.P.M.

Provider Business Mailing Address
First Line	:	PO BOX 815
Second Line	:
City	:	PACIFIC GROVE
State	:	CA
Zip	:	93950-0815
Country	:	US
Telephone Number	:	831-375-3789
Fax Number	:	831-375-1427

Provider Business Practice Location Address
First Line	:	1219 FOREST AVE
Second Line	:	SUITE G
City	:	PACIFIC GROVE
State	:	CA
Zip	:	93950-5136
Country	:	US
Telephone Number	:	831-375-3789
Fax Number	:	831-375-1427

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

Provider Enumeration Date	:	01/01/2007
Last Update Date	:	01/22/2015

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