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General NPI Number Information
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NPI Number | 1316098098
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Entity Type | Organization
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Legal Business Name | MARSHALL ORTHOPEDICS INC
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Dates
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Enumeration Date | 01/16/2007
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Last Update Date | 02/04/2008
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Provider Practice Location Address
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Address Line | 7300 GIRARD AVE 204
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City | LA JOLLA
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State | CA
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Zip | 92037-5138
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Country | US
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Telephone | 858-459-3710
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Fax | 858-459-3706
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Provider Business Mailing Address
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Address Line | 7300 GIRARD AVE 204
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City | LA JOLLA
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State | CA
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Zip | 92037
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Country | US
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Telephone | 858-459-3710
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Fax | 858-459-3706
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Authorized Official
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Title or Position | OWNER
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Name | STUART CHARLES MARSHALL
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Credential | M.D.
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Telephone | 858-459-3710
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | G21075
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License Number State | CA
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