Provider Demographics
NPI:1437104783
Name:AVENT, MARC R (DO)
Entity Type:Individual
Prefix:DR
First Name:MARC
Middle Name:R
Last Name:AVENT
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Gender:M
Credentials:DO
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Mailing Address - Street 1:7777 MILLIKEN AVE
Mailing Address - Street 2:STE 220
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91730-6780
Mailing Address - Country:US
Mailing Address - Phone:909-484-4234
Mailing Address - Fax:909-484-4235
Practice Address - Street 1:7777 MILLIKEN AVE
Practice Address - Street 2:STE 220
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91730-6780
Practice Address - Country:US
Practice Address - Phone:909-484-4234
Practice Address - Fax:909-484-4235
Is Sole Proprietor?:No
Enumeration Date:2006-05-24
Last Update Date:2011-04-20
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Provider Licenses
StateLicense IDTaxonomies
CA20A9174207Q00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA020A491740Medicare ID - Type UnspecifiedMEDICARE
CAI42784Medicare UPIN
020A91742Medicare PIN