Provider Demographics
NPI:1093986754
Name:MARQUIS, CHAD R (CPO)
Entity Type:Individual
Prefix:MR
First Name:CHAD
Middle Name:R
Last Name:MARQUIS
Suffix:
Gender:M
Credentials:CPO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:26300 LA ALAMEDA SUITE 120
Mailing Address - Street 2:
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92691
Mailing Address - Country:US
Mailing Address - Phone:949-272-2237
Mailing Address - Fax:
Practice Address - Street 1:26300 LA ALAMEDA STE 120
Practice Address - Street 2:
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92691-6380
Practice Address - Country:US
Practice Address - Phone:949-272-2237
Practice Address - Fax:949-367-0277
Is Sole Proprietor?:No
Enumeration Date:2008-03-20
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist
No222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist