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General NPI Number Information
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NPI Number | 1760137780
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Entity Type | Organization
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Legal Business Name | MARC MA FAMILY MEDICINE
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Dates
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Enumeration Date | 02/17/2022
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Last Update Date | 07/14/2022
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Provider Practice Location Address
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Address Line | 1818 SIERRA LEONE AVE STE E
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City | ROWLAND HEIGHTS
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State | CA
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Zip | 91748-3696
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Country | US
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Telephone | 626-600-8066
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Fax | 626-508-1280
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Provider Business Mailing Address
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Address Line | 1818 SIERRA LEONE AVE STE E
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City | ROWLAND HEIGHTS
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State | CA
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Zip | 91748-3696
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MARC MA
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Credential | MD
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Telephone | 626-536-7534
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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