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NPI Code Detail

MEDICARE: DR. WADIE L MARCOS DO

MEDICARE: DR. WADIE L MARCOS DO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician20A8922CA
2207Q00000XFamily Medicine Physician20A8922CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1508806027
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. WADIE L MARCOS DO
Provider Business Mailing Address
First Line : 3900 E PCH
Second Line :
City : LONG BEACH
State : CA
Zip : 90804-2013
Country : US
Telephone Number : 800-780-1230
Fax Number :
Provider Business Practice Location Address
First Line : 3900 E PCH
Second Line :
City : LONG BEACH
State : CA
Zip : 90804-2013
Country : US
Telephone Number : 800-780-1230
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/07/2006
Last Update Date : 12/17/2021

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