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General NPI Number Information
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NPI Number | 1417605700
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Entity Type | Organization
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Legal Business Name | MARQUE MEDICAL CLINIC, INC
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Dates
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Enumeration Date | 03/15/2022
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Last Update Date | 04/21/2022
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Provider Practice Location Address
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Address Line | 21771 LAKE FOREST DR STE 109
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City | LAKE FOREST
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State | CA
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Zip | 92630-2782
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Country | US
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Telephone | 714-707-6499
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Fax |
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Provider Business Mailing Address
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Address Line | 2075 SAN JOAQUIN HILLS RD
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City | NEWPORT BEACH
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State | CA
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Zip | 92660-6505
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Country | US
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Telephone | 714-707-6499
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Fax | 949-629-3509
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Authorized Official
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Title or Position | DIRECTOR, RCM
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Name | ALISA JONES
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Credential |
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Telephone | 949-529-8714
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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