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General NPI Number Information
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NPI Number | 1427153535
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Entity Type | Organization
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Legal Business Name | MARSHALL MEDICAL CENTER
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Dates
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Enumeration Date | 09/13/2006
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Last Update Date | 09/08/2020
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Provider Practice Location Address
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Address Line | 699 MAIN ST SUITE C
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City | PLACERVILLE
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State | CA
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Zip | 95667-5720
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Country | US
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Telephone | 530-626-2166
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Fax |
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Provider Business Mailing Address
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Address Line | P.O. BOX 45680
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City | SAN FRANCISCO
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State | CA
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Zip | 94145
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Country | US
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Telephone | 530-626-2155
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MRS. SIRI NELSON
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Credential |
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Telephone | 530-626-2601
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number |
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License Number State | CA
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