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General NPI Number Information
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NPI Number | 1851860316
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Entity Type | Individual
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Provider Name | EMMANUEL MARSEILLE CSA, MD, PA
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Gender | Male
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Dates
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Enumeration Date | 11/14/2018
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Last Update Date | 01/31/2026
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Provider Practice Location Address
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Address Line | 4700 S MCCLINTOCK DR STE 140
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City | TEMPE
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State | AZ
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Zip | 85282-7375
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Country | US
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Telephone | 480-851-6309
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Fax | 573-240-9791
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Provider Business Mailing Address
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Address Line | 14877 N 145TH DR
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City | SURPRISE
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State | AZ
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Zip | 85379-4765
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Country | US
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Telephone | 561-900-6083
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | 9583
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 9583
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License Number State | AZ
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