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General NPI Number Information
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NPI Number | 1033006309
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Entity Type | Organization
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Legal Business Name | MARLON MINERA, M.D., INC.
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Dates
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Enumeration Date | 06/19/2025
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Last Update Date | 10/12/2025
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Provider Practice Location Address
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Address Line | 6376 GREYSON WAY
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City | RIVERSIDE
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State | CA
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Zip | 92506-5333
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Country | US
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Telephone | 951-289-5087
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Fax |
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Provider Business Mailing Address
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Address Line | 17130 VAN BUREN BLVD # 1007
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City | RIVERSIDE
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State | CA
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Zip | 92504-5905
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Country | US
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Telephone | 951-289-5087
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MARLON GEOVANNY MINERA
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Credential | MD
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Telephone | 951-289-5087
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0300X
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Taxonomy Name | Geriatric Medicine (Internal Medicine) Physician
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License Number |
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License Number State |
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