Provider Demographics
NPI:1154507192
Name:MARSHBURN, JULIE A (MD)
Entity Type:Individual
Prefix:DR
First Name:JULIE
Middle Name:A
Last Name:MARSHBURN
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 1:1001 AVENIDA PICO
Mailing Address - Street 2:SUITE C #499
Mailing Address - City:SAN CLEMENTE
Mailing Address - State:CA
Mailing Address - Zip Code:92673-6957
Mailing Address - Country:US
Mailing Address - Phone:949-400-3906
Mailing Address - Fax:
Practice Address - Street 1:25401 CABOT RD
Practice Address - Street 2:SUITE 101
Practice Address - City:LAGUNA HILLS
Practice Address - State:CA
Practice Address - Zip Code:92653-5524
Practice Address - Country:US
Practice Address - Phone:949-768-4850
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-19
Last Update Date:2008-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA90111207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine