Provider Demographics
NPI:1841388907
Name:MARRONE, ALFRED C (MD)
Entity Type:Individual
Prefix:
First Name:ALFRED
Middle Name:C
Last Name:MARRONE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:420 E 3RD ST STE 603
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90013-1645
Mailing Address - Country:US
Mailing Address - Phone:213-625-2694
Mailing Address - Fax:213-680-9299
Practice Address - Street 1:23441 MADISON ST STE 120
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-4734
Practice Address - Country:US
Practice Address - Phone:310-530-0300
Practice Address - Fax:310-530-2367
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-11
Last Update Date:2019-10-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAG24447207W00000X, 208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADY3050OtherRAILROAD MEDICARE GROUP PTAN
CA756181273OtherRR MEDICARE