Provider Demographics
NPI:1760788566
Name:WRIGHT, MARC ELLIOTT (DO)
Entity Type:Individual
Prefix:DR
First Name:MARC
Middle Name:ELLIOTT
Last Name:WRIGHT
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5855 OLIVAS PARK DR
Mailing Address - Street 2:
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93003-7672
Mailing Address - Country:US
Mailing Address - Phone:805-667-2801
Mailing Address - Fax:805-667-2865
Practice Address - Street 1:422 ARNEILL RD
Practice Address - Street 2:STE B
Practice Address - City:CAMARILLO
Practice Address - State:CA
Practice Address - Zip Code:93010-6439
Practice Address - Country:US
Practice Address - Phone:805-383-4510
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-27
Last Update Date:2014-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A11430207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine