Doctor Name: | MR. MARC A MUNOZ |
NPI Number: | 1013186956 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | P.A. |
License Number: | PA15018 |
Business Practice Address: | 21030 Redwood Rd Castro Valley, CA - 945465920 |
Business Phone Number: | 5105380430 |
Business Fax Number: | 5105381839 |
Mailing Address: | 21030 Redwood Rd, CASTRO VALLEY |
State: | CA |
Postal Code: | 945465920 |
Phone Number: | 5105380430 |
Fax Number: | 5105381839 |
NPI Enumeration Date: | 02/25/2008 |
NPI Last Update Date: | 02/25/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | PA15018 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |