Provider Demographics
NPI:1467149054
Name:MESIAS, MARLON JR (RN)
Entity Type:Individual
Prefix:
First Name:MARLON
Middle Name:
Last Name:MESIAS
Suffix:JR
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:MARLON
Other - Middle Name:JUBAY
Other - Last Name:MESIAS
Other - Suffix:JR
Other - Last Name Type:Other Name
Other - Credentials:RN
Mailing Address - Street 1:1505 PLAZA DE NOCHE APT 7
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92882-2937
Mailing Address - Country:US
Mailing Address - Phone:949-288-1208
Mailing Address - Fax:
Practice Address - Street 1:3435 W BALL RD
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92804-3708
Practice Address - Country:US
Practice Address - Phone:714-827-5880
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-24
Last Update Date:2023-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95331667163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse