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General NPI Number Information
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NPI Number | 1174061733
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Entity Type | Organization
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Legal Business Name | WILLCYCLE PARTNERSHIPS, INC
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Dates
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Enumeration Date | 02/03/2017
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Last Update Date | 02/03/2017
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Provider Practice Location Address
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Address Line | 3750 SANTA ROSALIA DR SUITE 2
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City | LOS ANGELES
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State | CA
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Zip | 90008-3627
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Country | US
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Telephone | 909-559-6233
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Fax | 310-363-7079
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Provider Business Mailing Address
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Address Line | 3750 SANTA ROSALIA DR SUITE 2
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City | LOS ANGELES
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State | CA
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Zip | 90008-3627
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Country | US
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Telephone | 909-559-6233
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Fax | 310-363-7079
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MARLON MATTHEW FARLEY
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Credential | MD
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Telephone | 909-559-6233
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State | CA
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