Provider Demographics
NPI:1942574066
Name:MM OCCUPATIONAL MEDICINE CORP
Entity Type:Organization
Organization Name:MM OCCUPATIONAL MEDICINE CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:D
Authorized Official - Last Name:MARSH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:626-214-0127
Mailing Address - Street 1:750 TERRADO PLZ
Mailing Address - Street 2:SUITE 104
Mailing Address - City:COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91723-3419
Mailing Address - Country:US
Mailing Address - Phone:626-214-0127
Mailing Address - Fax:626-214-0128
Practice Address - Street 1:750 TERRADO PLZ
Practice Address - Street 2:SUITE 104
Practice Address - City:COVINA
Practice Address - State:CA
Practice Address - Zip Code:91723-3419
Practice Address - Country:US
Practice Address - Phone:626-214-0127
Practice Address - Fax:626-214-0128
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-07
Last Update Date:2012-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty