Provider Demographics
NPI:1396155685
Name:MARCHEVSKY, PABLO SEBASTIAN
Entity type:Individual
Prefix:
First Name:PABLO
Middle Name:SEBASTIAN
Last Name:MARCHEVSKY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1615 BUNKER HILL WAY
Mailing Address - Street 2:SUITE 140
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93906-6013
Mailing Address - Country:US
Mailing Address - Phone:831-796-1386
Mailing Address - Fax:
Practice Address - Street 1:29 BISHOP ST STE A
Practice Address - Street 2:
Practice Address - City:ROYAL OAKS
Practice Address - State:CA
Practice Address - Zip Code:95076
Practice Address - Country:US
Practice Address - Phone:831-728-2505
Practice Address - Fax:831-728-2636
Is Sole Proprietor?:No
Enumeration Date:2014-05-07
Last Update Date:2019-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
CA145296207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program