Provider Demographics
NPI:1912575853
Name:FEUZ, MARIKO (DO)
Entity type:Individual
Prefix:DR
First Name:MARIKO
Middle Name:
Last Name:FEUZ
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:MARI
Other - Middle Name:
Other - Last Name:FEUZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DO
Mailing Address - Street 1:4610 X ST STE 4202
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95817-2200
Mailing Address - Country:US
Mailing Address - Phone:916-734-7797
Mailing Address - Fax:
Practice Address - Street 1:4610 X ST STE 4202
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95817-2200
Practice Address - Country:US
Practice Address - Phone:916-734-7797
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-16
Last Update Date:2024-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAR-12102207R00000X
CA20A22735207RH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine