Provider Demographics
NPI:1245246164
Name:MARSHBURN, JOHN S (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:S
Last Name:MARSHBURN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1275 N ROSE DR
Mailing Address - Street 2:SUITE 112
Mailing Address - City:PLACENTIA
Mailing Address - State:CA
Mailing Address - Zip Code:92870-3941
Mailing Address - Country:US
Mailing Address - Phone:714-792-1199
Mailing Address - Fax:714-792-1196
Practice Address - Street 1:1275 N ROSE DR
Practice Address - Street 2:SUITE 112
Practice Address - City:PLACENTIA
Practice Address - State:CA
Practice Address - Zip Code:92870-3941
Practice Address - Country:US
Practice Address - Phone:714-792-1199
Practice Address - Fax:714-792-1196
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-31
Last Update Date:2007-11-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA60789207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA60789OtherSTATE LICENSE
CAF86321Medicare UPIN
CAA60789OtherSTATE LICENSE