Healthcare Provider Details

I. General information

NPI: 1770162919
Provider Name (Legal Business Name): JOBY MARIE VIRAY MARFORI DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/05/2021
Last Update Date: 11/14/2024
Certification Date: 11/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

72780 COUNTRY CLUB DR STE 203
RANCHO MIRAGE CA
92270-4150
US

IV. Provider business mailing address

39000 BOB HOPE DR
RANCHO MIRAGE CA
92270-3221
US

V. Phone/Fax

Practice location:
  • Phone: 760-834-3593
  • Fax: 760-674-3845
Mailing address:
  • Phone: 760-340-3911
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number20A21888
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: