Provider Demographics
NPI:1225643729
Name:DEL RIO MARQUEZ, OSCAR (DC)
Entity Type:Individual
Prefix:
First Name:OSCAR
Middle Name:
Last Name:DEL RIO MARQUEZ
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6019 PINE AVE
Mailing Address - Street 2:
Mailing Address - City:MAYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90270-3108
Mailing Address - Country:US
Mailing Address - Phone:323-506-4194
Mailing Address - Fax:
Practice Address - Street 1:6019 PINE AVE
Practice Address - Street 2:
Practice Address - City:MAYWOOD
Practice Address - State:CA
Practice Address - Zip Code:90270-3108
Practice Address - Country:US
Practice Address - Phone:323-506-4194
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-11
Last Update Date:2020-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC34452111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty