Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | A94282 | CA |
N | 208600000X | Surgeon | A94282 | CA |
Y | 2086S0129X | Vascular Surgeon | N7138 | TX |
NPI | 1124208459 |
---|---|
Provider Name | Christopher Julian Marrocco |
First Address | Lynwood, CA 90262-2659 |
Second Address | Lynwood, CA 90262-2659 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/11/2007 |
Last Update Date | 05/08/2014 |