Provider Demographics
NPI:1417013558
Name:MARCUS, ALON (DOM)
Entity Type:Individual
Prefix:DR
First Name:ALON
Middle Name:
Last Name:MARCUS
Suffix:
Gender:M
Credentials:DOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 29TH ST
Mailing Address - Street 2:SUITE 419
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94609-3522
Mailing Address - Country:US
Mailing Address - Phone:510-452-5034
Mailing Address - Fax:
Practice Address - Street 1:400 29TH ST
Practice Address - Street 2:SUITE 419
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94609-3522
Practice Address - Country:US
Practice Address - Phone:510-452-5034
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACL2345171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist