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General NPI Number Information
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NPI Number | 1366584328
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Entity Type | Organization
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Legal Business Name | EVA TERESA MARSHALL, M.D., A MEDICAL CORPORATION
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Dates
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Enumeration Date | 02/13/2007
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Last Update Date | 04/09/2012
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Provider Practice Location Address
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Address Line | 3020 H ST
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City | EUREKA
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State | CA
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Zip | 95501-4410
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Country | US
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Telephone | 707-445-5900
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Fax | 707-445-2686
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Provider Business Mailing Address
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Address Line | PO BOX 496084
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City | REDDING
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State | CA
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Zip | 96049-6084
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Country | US
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Telephone | 707-445-5900
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Fax | 707-445-2686
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Authorized Official
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Title or Position | PRESIDENT
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Name | EVA TERESA MARSHALL
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Credential | M.D.
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Telephone | 707-445-5900
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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 | A63543
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License Number State | CA
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