Provider Demographics
NPI:1558712968
Name:MARQUEZ, HARKIRAN J
Entity Type:Individual
Prefix:
First Name:HARKIRAN
Middle Name:J
Last Name:MARQUEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:HARKIRAN
Other - Middle Name:
Other - Last Name:KAUR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:129 VIOLET AVE
Mailing Address - Street 2:APT # 207
Mailing Address - City:MONROVIA
Mailing Address - State:CA
Mailing Address - Zip Code:91016-2667
Mailing Address - Country:US
Mailing Address - Phone:562-400-3788
Mailing Address - Fax:
Practice Address - Street 1:129 VIOLET AVE
Practice Address - Street 2:APT 207
Practice Address - City:MONROVIA
Practice Address - State:CA
Practice Address - Zip Code:91016-2667
Practice Address - Country:US
Practice Address - Phone:562-400-3788
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-27
Last Update Date:2024-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95000572367500000X, 367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered