Provider Demographics
NPI:1104962042
Name:MARAIO, GINA (DO)
Entity type:Individual
Prefix:DR
First Name:GINA
Middle Name:
Last Name:MARAIO
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:1547 MISSION MEADOWS DR
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92057-4804
Mailing Address - Country:US
Mailing Address - Phone:760-908-3080
Mailing Address - Fax:760-940-1545
Practice Address - Street 1:1547 MISSION MEADOWS DR
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:CA
Practice Address - Zip Code:92057-4804
Practice Address - Country:US
Practice Address - Phone:760-908-3080
Practice Address - Fax:760-940-1545
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-29
Last Update Date:2020-08-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA20A7479207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAH61885Medicare UPIN