MEDICARE: CLAUDIO MARCELO DEMB 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
1	2084P0800X	Psychiatry Physician	193874	CA
2	2084P0800X	Psychiatry Physician	152845	MA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	152845	OTHER	MA	TUFTS
3	J18089	OTHER	MA	BLUECROSS

General Provider Information

NPI Number	:	1730174921
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CLAUDIO MARCELO DEMB M.D.

Provider Business Mailing Address
First Line	:	8950 VILLA LA JOLLA DR STE C230
Second Line	:
City	:	LA JOLLA
State	:	CA
Zip	:	92037-1712
Country	:	US
Telephone Number	:	925-282-1778
Fax Number	:	415-296-5299

Provider Business Practice Location Address
First Line	:	8950 VILLA LA JOLLA DR STE C230
Second Line	:
City	:	LA JOLLA
State	:	CA
Zip	:	92037-1712
Country	:	US
Telephone Number	:	925-282-1778
Fax Number	:	415-296-5299

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

Provider Enumeration Date	:	09/14/2005
Last Update Date	:	04/16/2024

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