Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 170100000X | Medical Geneticist | A66358 | CA |
NPI | 1275678583 |
---|---|
Provider Name | Rim Marcinkus |
First Address | Rancho Mirage, CA 92270-1753 |
Second Address | Rancho Mirage, CA 92270-1753 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/02/2007 |
Last Update Date | 08/07/2007 |