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General NPI Number Information
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NPI Number | 1780987537
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Entity Type | Organization
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Legal Business Name | LUIS MARMANILLO-ALCAZAR, M.D.,INC.
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Dates
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Enumeration Date | 12/17/2010
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Last Update Date | 08/15/2011
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Provider Practice Location Address
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Address Line | 340 4TH AVE SUITE 17
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City | CHULA VISTA
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State | CA
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Zip | 91910-3813
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Country | US
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Telephone | 619-585-7117
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Fax | 619-585-7146
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Provider Business Mailing Address
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Address Line | 340 4TH AVE SUITE 17
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City | CHULA VISTA
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State | CA
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Zip | 91910-3813
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Country | US
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Telephone | 619-585-7117
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Fax | 619-585-7146
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MR. LUIS JORGE MARMANILLO
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Credential | M.D.
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Telephone | 619-585-7117
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VX0000X
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Taxonomy Name | Obstetrics Physician
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License Number |
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License Number State |
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