Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VG0400X | Gynecologist | G37441 | CA |
NPI | 1013014612 |
---|---|
Provider Name | Dr. Walter M Marcus |
First Address | Riverside, CA 92503 |
Second Address | Riverside, CA 92503 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/09/2006 |
Last Update Date | 04/02/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00G377410 | (05) | CA |
A47087 | (02) |