Provider Demographics
NPI:1124208459
Name:MARROCCO, CHRISTOPHER JULIAN (MD)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:JULIAN
Last Name:MARROCCO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3680 E IMPERIAL HWY
Mailing Address - Street 2:SUITE 502
Mailing Address - City:LYNWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90262-2659
Mailing Address - Country:US
Mailing Address - Phone:562-698-0271
Mailing Address - Fax:562-698-7467
Practice Address - Street 1:3680 E IMPERIAL HWY
Practice Address - Street 2:SUITE 502
Practice Address - City:LYNWOOD
Practice Address - State:CA
Practice Address - Zip Code:90262-2659
Practice Address - Country:US
Practice Address - Phone:562-698-0271
Practice Address - Fax:562-698-7467
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-03
Last Update Date:2014-08-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA94282208600000X
TXN71382086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery