Provider Demographics
NPI:1689045486
Name:TAPORCO, MARLENE SHARI
Entity Type:Individual
Prefix:
First Name:MARLENE SHARI
Middle Name:
Last Name:TAPORCO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1120 IRONWOOD CIR
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:94533-7744
Mailing Address - Country:US
Mailing Address - Phone:707-580-8007
Mailing Address - Fax:
Practice Address - Street 1:2059 CADENASSO DR
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:CA
Practice Address - Zip Code:94533-6806
Practice Address - Country:US
Practice Address - Phone:707-759-0005
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-19
Last Update Date:2015-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA73289183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist