Provider Demographics
NPI:1083860449
Name:MARSEILLE, DANA MARIE (MD)
Entity Type:Individual
Prefix:
First Name:DANA
Middle Name:MARIE
Last Name:MARSEILLE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4650 SUNSET BLVD, MAILSTOP #113
Mailing Address - Street 2:DEPARTMENT OF EMERGENCY MEDICINE AND TRANSPORT
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90027
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4650 SUNSET BLVD, MAILSTOP #113
Practice Address - Street 2:CHLA, EMERGENCY MEDICINE AND TRANSPORT
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90027
Practice Address - Country:US
Practice Address - Phone:323-361-6522
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-16
Last Update Date:2013-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA105250208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics