| Doctor Name: | DR. MARIE ANSON-REBONG |
| NPI Number: | 1982611349 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.D. |
| License Number: | A45814 |
| Business Practice Address: | 2350 Mckee Road Ste 1 San Jose, CA - 951161606 |
| Business Phone Number: | 4087293232 |
| Business Fax Number: | 4087292165 |
| Mailing Address: | 2350 Mckee Road, Ste 1 SAN JOSE |
| State: | CA |
| Postal Code: | 951161606 |
| Phone Number: | 4087293232 |
| Fax Number: | 4087292165 |
| NPI Enumeration Date: | 08/01/2006 |
| NPI Last Update Date: | 10/30/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | A45814 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | CA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |