Provider Demographics
NPI:1164149852
Name:COCSON, MARWILL DAVID RAMIRO (PT)
Entity Type:Individual
Prefix:
First Name:MARWILL DAVID
Middle Name:RAMIRO
Last Name:COCSON
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3066 SOSCOL AVE
Mailing Address - Street 2:
Mailing Address - City:NAPA
Mailing Address - State:CA
Mailing Address - Zip Code:94558-3053
Mailing Address - Country:US
Mailing Address - Phone:415-275-4873
Mailing Address - Fax:
Practice Address - Street 1:2100 REDWOOD RD
Practice Address - Street 2:
Practice Address - City:NAPA
Practice Address - State:CA
Practice Address - Zip Code:94558-3279
Practice Address - Country:US
Practice Address - Phone:707-260-1010
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-24
Last Update Date:2023-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT302935225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist