Provider Demographics
NPI:1013625706
Name:MARQUE MEDICAL CLINIC, INC
Entity Type:Organization
Organization Name:MARQUE MEDICAL CLINIC, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR, RCM
Authorized Official - Prefix:
Authorized Official - First Name:ALISA
Authorized Official - Middle Name:
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:877-693-6266
Mailing Address - Street 1:2075 SAN JOAQUIN HILLS RD STE 800
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-6505
Mailing Address - Country:US
Mailing Address - Phone:877-693-6266
Mailing Address - Fax:
Practice Address - Street 1:9630 SIERRA AVE STE 100
Practice Address - Street 2:
Practice Address - City:FONTANA
Practice Address - State:CA
Practice Address - Zip Code:92335-2415
Practice Address - Country:US
Practice Address - Phone:877-693-6266
Practice Address - Fax:949-629-3509
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MARQUE MEDICAL CLINIC, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-11-10
Last Update Date:2022-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care