Healthcare Provider Details

I. General information

NPI: 1427392414
Provider Name (Legal Business Name): BRIAN ALLEN MARCHIONE DVM, DACVO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/15/2012
Last Update Date: 11/09/2022
Certification Date: 11/09/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9854 NATIONAL BLVD # 440
LOS ANGELES CA
90034-2713
US

IV. Provider business mailing address

9854 NATIONAL BLVD # 440
LOS ANGELES CA
90034-2713
US

V. Phone/Fax

Practice location:
  • Phone: 310-862-2133
  • Fax:
Mailing address:
  • Phone: 310-862-2133
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174M00000X
TaxonomyVeterinarian
License Number16690
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: