Healthcare Provider Details

I. General information

NPI: 1659554285
Provider Name (Legal Business Name): MARSHALL MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/05/2007
Last Update Date: 03/09/2026
Certification Date: 03/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3581 PALMER DR SUITE 400
CAMERON PARK CA
95682-8236
US

IV. Provider business mailing address

PO BOX 45680
SAN FRANCISCO CA
94145-0680
US

V. Phone/Fax

Practice location:
  • Phone: 530-676-6600
  • Fax: 530-676-6603
Mailing address:
  • Phone: 530-626-2787
  • Fax: 530-626-2839

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number
License Number State

VIII. Authorized Official

Name: SIRI NELSON
Title or Position: CEO
Credential:
Phone: 530-622-1441