Provider Demographics
NPI:1699983114
Name:MARRONE, JAMES RICHARD (MD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:RICHARD
Last Name:MARRONE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1468 N PINEBROOK AVE
Mailing Address - Street 2:
Mailing Address - City:UPLAND
Mailing Address - State:CA
Mailing Address - Zip Code:91786-2680
Mailing Address - Country:US
Mailing Address - Phone:909-204-2821
Mailing Address - Fax:909-204-2821
Practice Address - Street 1:1468 N PINEBROOK AVE
Practice Address - Street 2:
Practice Address - City:UPLAND
Practice Address - State:CA
Practice Address - Zip Code:91786-2680
Practice Address - Country:US
Practice Address - Phone:909-204-2821
Practice Address - Fax:909-204-2821
Is Sole Proprietor?:No
Enumeration Date:2007-05-18
Last Update Date:2016-10-28
Deactivation Date:2007-07-17
Deactivation Code:
Reactivation Date:2016-10-21
Provider Licenses
StateLicense IDTaxonomies
CAA066870208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics