Provider Demographics
NPI:1336467281
Name:DABCEVIC, MARINA
Entity Type:Individual
Prefix:
First Name:MARINA
Middle Name:
Last Name:DABCEVIC
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1512 BRUINBARK LN
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-5668
Mailing Address - Country:US
Mailing Address - Phone:310-528-3309
Mailing Address - Fax:
Practice Address - Street 1:1512 BRUINBARK LN
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-5668
Practice Address - Country:US
Practice Address - Phone:310-528-3309
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-16
Last Update Date:2010-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist