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General NPI Number Information
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NPI Number | 1215745377
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Entity Type | Individual
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Provider Name | RACHEL MARCUS NURSE PRACTITIONER
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Gender | Female
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Dates
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Enumeration Date | 12/20/2024
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Last Update Date | 12/20/2024
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Provider Practice Location Address
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Address Line | 770 MAGNOLIA AVE STE 2A
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City | CORONA
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State | CA
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Zip | 92879-3122
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Country | US
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Telephone | 951-736-8144
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Fax |
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Provider Business Mailing Address
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Address Line | 2960 CHAMPION WAY APT 1307
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City | TUSTIN
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State | CA
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Zip | 92782-1215
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Country | US
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Telephone | 502-475-3311
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 95032681
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 1158951
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License Number State | KY
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Taxonomy #3
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 95230406
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License Number State | CA
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