Healthcare Provider Details

I. General information

NPI: 1952592743
Provider Name (Legal Business Name): DEREK KEVIN MARSEE MD, PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/06/2007
Last Update Date: 04/07/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3301 C STREET SUITE 200-E
SACRAMENTO CA
95816-3363
US

IV. Provider business mailing address

3301 C STREET SUITE 200-E
SACRAMENTO CA
95816-3363
US

V. Phone/Fax

Practice location:
  • Phone: 916-447-6267
  • Fax: 916-456-5842
Mailing address:
  • Phone: 916-447-6267
  • Fax: 916-456-5842

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number225277
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: