Provider Demographics
NPI:1730078718
Name:MARSHALL, MADISON NOEL (LM, CPM)
Entity type:Individual
Prefix:
First Name:MADISON
Middle Name:NOEL
Last Name:MARSHALL
Suffix:
Gender:F
Credentials:LM, CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3301 WIMBLETON DR
Mailing Address - Street 2:
Mailing Address - City:LOS ALAMITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90720-3852
Mailing Address - Country:US
Mailing Address - Phone:949-945-8701
Mailing Address - Fax:
Practice Address - Street 1:5175 E PACIFIC COAST HWY STE 402
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90804-3313
Practice Address - Country:US
Practice Address - Phone:530-237-7755
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-02
Last Update Date:2025-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALM770176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife