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NPI Code Detail

MEDICARE: MARVIS YVONNE SORRELL D.M.D., M.D.S.

MEDICARE:   MARVIS YVONNE SORRELL  D.M.D., M.D.S.
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
11223X0400XOrthodontics and Dentofacial Orthopedics Dentistry031711CA

General Provider Information

NPI Number : 1578621801
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARVIS YVONNE SORRELL D.M.D., M.D.S.
Provider Business Mailing Address
First Line : 1777 N BELLFLOWER BLVD
Second Line : #202
City : LONG BEACH
State : CA
Zip : 90815-4020
Country : US
Telephone Number : 562-597-3639
Fax Number : 562-597-6236
Provider Business Practice Location Address
First Line : 1777 N BELLFLOWER BLVD
Second Line : #202
City : LONG BEACH
State : CA
Zip : 90815-4020
Country : US
Telephone Number : 562-597-3639
Fax Number : 562-597-6236
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/06/2006
Last Update Date : 06/22/2010

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Directions to “ MARVIS YVONNE SORRELL D.M.D., M.D.S.” Practice Location

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