Provider Demographics
NPI:1528069812
Name:MARZELL, MARILYN KAY (PAC)
Entity type:Individual
Prefix:MS
First Name:MARILYN
Middle Name:KAY
Last Name:MARZELL
Suffix:
Gender:F
Credentials:PAC
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:9 CRESTVIEW DR
Mailing Address - Street 2:
Mailing Address - City:WATSONVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95076-2723
Mailing Address - Country:US
Mailing Address - Phone:831-763-8400
Mailing Address - Fax:831-763-8237
Practice Address - Street 1:9 CRESTVIEW DR
Practice Address - Street 2:
Practice Address - City:WATSONVILLE
Practice Address - State:CA
Practice Address - Zip Code:95076-2723
Practice Address - Country:US
Practice Address - Phone:831-763-8400
Practice Address - Fax:831-763-8327
Is Sole Proprietor?:No
Enumeration Date:2005-08-09
Last Update Date:2010-07-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA12092363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant