Provider Demographics
NPI:1275613093
Name:SEDWITZ, MARC M (MD)
Entity Type:Individual
Prefix:
First Name:MARC
Middle Name:M
Last Name:SEDWITZ
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:9850 GENESEE AVE
Mailing Address - Street 2:SUITE 560
Mailing Address - City:LA JOLLA
Mailing Address - State:CA
Mailing Address - Zip Code:92037-1224
Mailing Address - Country:US
Mailing Address - Phone:858-452-0306
Mailing Address - Fax:858-452-1421
Practice Address - Street 1:9850 GENESEE AVE
Practice Address - Street 2:SUITE 560
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92037-1224
Practice Address - Country:US
Practice Address - Phone:858-452-0306
Practice Address - Fax:858-452-1421
Is Sole Proprietor?:No
Enumeration Date:2006-10-16
Last Update Date:2011-08-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAG498952086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G498950Medicaid
CA00G498950Medicaid
CAWG49895DMedicare PIN