Provider Demographics
NPI:1972752202
Name:REUTHER, MARSHA SONIA KADZE (MD)
Entity Type:Individual
Prefix:
First Name:MARSHA
Middle Name:SONIA KADZE
Last Name:REUTHER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MARSHA
Other - Middle Name:SONIA
Other - Last Name:KADZE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:521 E ELDER ST
Mailing Address - Street 2:STE 104
Mailing Address - City:FALLBROOK
Mailing Address - State:CA
Mailing Address - Zip Code:92028-3082
Mailing Address - Country:US
Mailing Address - Phone:951-566-5229
Mailing Address - Fax:
Practice Address - Street 1:9834 GENESEE AVE
Practice Address - Street 2:STE 111
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92037-1214
Practice Address - Country:US
Practice Address - Phone:858-909-0770
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-10
Last Update Date:2019-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA110235207Y00000X, 207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology