Provider Demographics
NPI:1649490046
Name:MCCARTNEY, MARILYN CHRISTINE (MD)
Entity type:Individual
Prefix:
First Name:MARILYN
Middle Name:CHRISTINE
Last Name:MCCARTNEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6955 FOOTHILL BLVD
Mailing Address - Street 2:#200
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94605
Mailing Address - Country:US
Mailing Address - Phone:510-567-5700
Mailing Address - Fax:510-568-1321
Practice Address - Street 1:6955 FOOTHILL BLVD
Practice Address - Street 2:#200
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94605-2409
Practice Address - Country:US
Practice Address - Phone:510-567-5700
Practice Address - Fax:510-568-1321
Is Sole Proprietor?:No
Enumeration Date:2007-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG62671207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA81448Medicare UPIN