MEDICARE: DR. JOSEPH T. MARINO JR. 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	2080P0214X	Pediatric Pulmonology Physician	G387420	CA
2	207K00000X	Allergy & Immunology Physician	G387420	CA

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

General Provider Information

NPI Number	:	1760500797
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOSEPH T. MARINO JR. M.D.

Provider Business Mailing Address
First Line	:	1111 EXPOSITION BLVD STE 700
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95815-4314
Country	:	US
Telephone Number	:	916-736-3399
Fax Number	:	916-233-4171

Provider Business Practice Location Address
First Line	:	6600 MERCY CT STE 180B
Second Line	:
City	:	FAIR OAKS
State	:	CA
Zip	:	95628-3198
Country	:	US
Telephone Number	:	916-962-3112
Fax Number	:	916-962-1536

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

Provider Enumeration Date	:	03/27/2007
Last Update Date	:	05/14/2020

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Directions to “ DR. JOSEPH T. MARINO JR. M.D.” Practice Location

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