Provider Demographics
NPI:1093091605
Name:VERCELES, MARVELUZ ABAD (MEDICAL ASSISTANT)
Entity Type:Individual
Prefix:MRS
First Name:MARVELUZ
Middle Name:ABAD
Last Name:VERCELES
Suffix:
Gender:F
Credentials:MEDICAL ASSISTANT
Other - Prefix:MISS
Other - First Name:MARVELUZ
Other - Middle Name:ONERA
Other - Last Name:ABAD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:N/A
Mailing Address - Street 1:3131 CAUBY ST
Mailing Address - Street 2:APARTMENT 23
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92110-4613
Mailing Address - Country:US
Mailing Address - Phone:619-799-0425
Mailing Address - Fax:
Practice Address - Street 1:2051 CUSHING RD
Practice Address - Street 2:NAVAL BRANCH HEALTH CLINIC, NTC
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92106-6173
Practice Address - Country:US
Practice Address - Phone:619-524-5720
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-26
Last Update Date:2011-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor