Provider Demographics
NPI:1992867865
Name:MARSHALL, TIMOTHY PATRICK (HS)
Entity Type:Individual
Prefix:MR
First Name:TIMOTHY
Middle Name:PATRICK
Last Name:MARSHALL
Suffix:
Gender:M
Credentials:HS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 630053
Mailing Address - Street 2:
Mailing Address - City:SIMI VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93063-0001
Mailing Address - Country:US
Mailing Address - Phone:510-437-3981
Mailing Address - Fax:510-437-3521
Practice Address - Street 1:COMDT CG-1122 U S COAST GUARD
Practice Address - Street 2:2100 2ND ST SW, SUITE 5314
Practice Address - City:WASHINGTON, DC
Practice Address - State:DC
Practice Address - Zip Code:20593-0001
Practice Address - Country:US
Practice Address - Phone:510-437-3981
Practice Address - Fax:510-437-3521
Is Sole Proprietor?:No
Enumeration Date:2006-12-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other