Provider Demographics
NPI:1841734084
Name:MAUS, MARLON (MD DRPH)
Entity type:Individual
Prefix:DR
First Name:MARLON
Middle Name:
Last Name:MAUS
Suffix:
Gender:M
Credentials:MD DRPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2616 ETNA ST
Mailing Address - Street 2:
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94704-3409
Mailing Address - Country:US
Mailing Address - Phone:510-644-1718
Mailing Address - Fax:
Practice Address - Street 1:2616 ETNA ST
Practice Address - Street 2:
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94704-3409
Practice Address - Country:US
Practice Address - Phone:510-644-1718
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-07
Last Update Date:2016-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG87125207WX0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0200XAllopathic & Osteopathic PhysiciansOphthalmologyOphthalmic Plastic and Reconstructive Surgery