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NPI Code Detail

MEDICARE: DR. CALVIN MARANTZ M.D.

MEDICARE: DR. CALVIN MARANTZ M.D.
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
1207ZD0900XDermatopathology (Pathology) PhysicianG12076CA
2207ZP0102XAnatomic Pathology & Clinical Pathology PhysicianG12076CA

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 : 1639171788
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CALVIN MARANTZ M.D.
Provider Business Mailing Address
First Line : PO BOX 3553
Second Line :
City : MISSION VIEJO
State : CA
Zip : 92690-1553
Country : US
Telephone Number : 949-347-8441
Fax Number : 949-347-8443
Provider Business Practice Location Address
First Line : 800 S MAIN ST
Second Line :
City : CORONA
State : CA
Zip : 92882-3420
Country : US
Telephone Number : 951-736-6383
Fax Number : 951-736-6384
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/01/2005
Last Update Date : 09/11/2025

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