Provider Demographics
NPI:1801941976
Name:MARQUEZ, EUGENE JASO (BS)
Entity type:Individual
Prefix:MR
First Name:EUGENE
Middle Name:JASO
Last Name:MARQUEZ
Suffix:
Gender:M
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4024 DURFEE AVE
Mailing Address - Street 2:
Mailing Address - City:EL MONTE
Mailing Address - State:CA
Mailing Address - Zip Code:91732-2510
Mailing Address - Country:US
Mailing Address - Phone:626-471-6535
Mailing Address - Fax:
Practice Address - Street 1:4024 DURFEE AVE
Practice Address - Street 2:
Practice Address - City:EL MONTE
Practice Address - State:CA
Practice Address - Zip Code:91732-2510
Practice Address - Country:US
Practice Address - Phone:213-305-3712
Practice Address - Fax:626-455-4608
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-25
Last Update Date:2013-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator