MEDICARE: ANDREW MARQUES

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
1	225200000X	Physical Therapy Assistant

General Provider Information

NPI Number	:	1598417388
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDREW MARQUES

Provider Business Mailing Address
First Line	:	1389 ROXBOROUGH DR
Second Line	:
City	:	PLACENTIA
State	:	CA
Zip	:	92870-3524
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3901 E 4TH ST
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90814-1632
Country	:	US
Telephone Number	:	562-434-8421
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/22/2022
Last Update Date	:	01/22/2022

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Directions to “ ANDREW MARQUES ” Practice Location

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