MEDICARE: ADRIANNA LETRICE MARCUS PA-C

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	363A00000X	Physician Assistant	57370	CA

General Provider Information

NPI Number	:	1720620362
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ADRIANNA LETRICE MARCUS PA-C

Provider Business Mailing Address
First Line	:	2570 48TH ST
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95817-1541
Country	:	US
Telephone Number	:	916-734-2145
Fax Number	:

Provider Business Practice Location Address
First Line	:	520 BOGUE RD
Second Line	:
City	:	YUBA CITY
State	:	CA
Zip	:	95991-9242
Country	:	US
Telephone Number	:	661-364-7626
Fax Number	:

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

Provider Enumeration Date	:	10/15/2019
Last Update Date	:	10/15/2019

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