Provider Demographics
NPI:1972522480
Name:MARINOFF, DAVID N (MD, FACOG)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:N
Last Name:MARINOFF
Suffix:
Gender:M
Credentials:MD, FACOG
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:350 30TH ST
Mailing Address - Street 2:SUITE 208
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94609-3424
Mailing Address - Country:US
Mailing Address - Phone:510-444-0790
Mailing Address - Fax:510-869-6225
Practice Address - Street 1:350 30TH ST
Practice Address - Street 2:SUITE 208
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94609-3424
Practice Address - Country:US
Practice Address - Phone:510-444-0790
Practice Address - Fax:510-869-6225
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2008-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG44102207VM0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ96415ZMedicare PIN
CAA92468Medicare UPIN