=====================================================
General NPI Number Information
=====================================================
NPI Number | 1164149852
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MARWILL DAVID RAMIRO COCSON PT
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/24/2022
-----------------------------------------------------
Last Update Date | 11/06/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3421 VILLA LN STE 1A
-----------------------------------------------------
City | NAPA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 94558-3060
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 707-257-4089
-----------------------------------------------------
Fax | 707-257-4188
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3066 SOSCOL AVE
-----------------------------------------------------
City | NAPA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 94558-3053
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 415-275-4873
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225100000X
-----------------------------------------------------
Taxonomy Name | Physical Therapist
-----------------------------------------------------
License Number | PT302935
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------