Provider Demographics
NPI:1598721003
Name:FRANCISCO, MARIE PEARL C (MD)
Entity Type:Individual
Prefix:
First Name:MARIE PEARL
Middle Name:C
Last Name:FRANCISCO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MARIE
Other - Middle Name:P
Other - Last Name:CABRERA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1805 N CALIFORNIA ST
Mailing Address - Street 2:SUITE 206
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95204-6037
Mailing Address - Country:US
Mailing Address - Phone:209-948-3009
Mailing Address - Fax:209-948-3003
Practice Address - Street 1:1805 N CALIFORNIA ST
Practice Address - Street 2:SUITE 206
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95204-6037
Practice Address - Country:US
Practice Address - Phone:209-948-3009
Practice Address - Fax:209-948-3003
Is Sole Proprietor?:No
Enumeration Date:2006-04-24
Last Update Date:2015-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA91644207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A916440Medicaid
CAI46637Medicare UPIN
CA00G389150Medicare ID - Type UnspecifiedMEDICARE NUMBER