Healthcare Provider Details

I. General information

NPI: 1285829150
Provider Name (Legal Business Name): MARLENE CARINO TUSCANO M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/13/2007
Last Update Date: 02/28/2023
Certification Date: 02/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

202 N 8TH ST
EL CENTRO CA
92243-2302
US

IV. Provider business mailing address

7328 E WILSHIRE DR
SCOTTSDALE AZ
85257-1441
US

V. Phone/Fax

Practice location:
  • Phone: 442-265-1525
  • Fax:
Mailing address:
  • Phone: 480-492-6367
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License NumberA97196
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: