Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife | LM0010 | CA |
NPI | 1124058565 |
---|---|
Provider Name | Ms. Tosi Marceline |
First Address | Davis, CA 95616-9443 |
Second Address | Davis, CA 95616-9443 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/07/2006 |
Last Update Date | 08/07/2007 |