Provider Demographics
NPI:1871997577
Name:MARQUEZ, ORLANDO V (INDEPENDENT DUTY HM)
Entity type:Individual
Prefix:
First Name:ORLANDO
Middle Name:V
Last Name:MARQUEZ
Suffix:
Gender:M
Credentials:INDEPENDENT DUTY HM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1954 TRUXTUN RD
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92106-6463
Mailing Address - Country:US
Mailing Address - Phone:619-487-0690
Mailing Address - Fax:
Practice Address - Street 1:UNIT 38404, 3D MLG, CLR 37, KGAS
Practice Address - Street 2:
Practice Address - City:FPO
Practice Address - State:AP
Practice Address - Zip Code:96480-8404
Practice Address - Country:US
Practice Address - Phone:315-637-1250
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-09
Last Update Date:2014-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1002XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Corpsman