Provider Demographics
NPI:1073576351
Name:MARX, ROBERT J (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:J
Last Name:MARX
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:14911 NATIONAL AVE
Mailing Address - Street 2:SUITE # 7
Mailing Address - City:LOS GATOS
Mailing Address - State:CA
Mailing Address - Zip Code:95032-2632
Mailing Address - Country:US
Mailing Address - Phone:408-358-3511
Mailing Address - Fax:408-358-0012
Practice Address - Street 1:14911 NATIONAL AVE
Practice Address - Street 2:SUITE # 7
Practice Address - City:LOS GATOS
Practice Address - State:CA
Practice Address - Zip Code:95032-2632
Practice Address - Country:US
Practice Address - Phone:408-358-3511
Practice Address - Fax:408-358-0012
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-08
Last Update Date:2010-08-31
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA30254208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA30254OtherSTATE LICENSE
CAA30254OtherSTATE LICENSE
CA00A302540Medicare ID - Type Unspecified