Healthcare Provider Details

I. General information

NPI: 1225529167
Provider Name (Legal Business Name): MARCUS THEUS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/26/2018
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2025 MORSE AVE
SACRAMENTO CA
95825-2115
US

IV. Provider business mailing address

2025 MORSE AVE
SACRAMENTO CA
95825-2115
US

V. Phone/Fax

Practice location:
  • Phone: 916-973-6600
  • Fax:
Mailing address:
  • Phone: 916-973-6600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number23601
License Number StateNV
# 2
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberA163877
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: