Healthcare Provider Details

I. General information

NPI: 1710628243
Provider Name (Legal Business Name): JESS ALEXANDER MARLOW MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: ALEX MARLOW MD

II. Dates (important events)

Enumeration Date: 04/06/2022
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3120 BIOMEDICAL SCIENCES WY
LA JOLLA CA
92093-0001
US

IV. Provider business mailing address

3120 BIOMEDICAL SCIENCES WY
LA JOLLA CA
92093-0001
US

V. Phone/Fax

Practice location:
  • Phone: 858-534-7792
  • Fax:
Mailing address:
  • Phone: 858-534-7792
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberA211349
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: