Provider Demographics
NPI:1659406825
Name:LAY, JOHN MARCUS (DO)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:MARCUS
Last Name:LAY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:10098 SOQUEL DR
Mailing Address - Street 2:
Mailing Address - City:APTOS
Mailing Address - State:CA
Mailing Address - Zip Code:95003-4926
Mailing Address - Country:US
Mailing Address - Phone:831-688-3112
Mailing Address - Fax:831-685-2614
Practice Address - Street 1:10098 SOQUEL DR
Practice Address - Street 2:
Practice Address - City:APTOS
Practice Address - State:CA
Practice Address - Zip Code:95003-4926
Practice Address - Country:US
Practice Address - Phone:831-688-3112
Practice Address - Fax:831-685-2614
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-21
Last Update Date:2012-02-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA020A41460207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine