Provider Demographics
NPI:1780101766
Name:MARSHALL, ANDRE ORLANDO (RPFT)
Entity type:Individual
Prefix:MR
First Name:ANDRE
Middle Name:ORLANDO
Last Name:MARSHALL
Suffix:
Gender:M
Credentials:RPFT
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Mailing Address - Street 1:2053 MARENGO ST
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90033-1352
Mailing Address - Country:US
Mailing Address - Phone:323-409-1267
Mailing Address - Fax:323-441-8202
Practice Address - Street 1:2053 MARENGO ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90033-1352
Practice Address - Country:US
Practice Address - Phone:323-409-1267
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-29
Last Update Date:2017-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA2279P1006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2279P1006XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, RegisteredPulmonary Function Technologist