Most Relevant Information
Provider Data
| NPI Number: | 1003585399 |
| Provider Name: | DESMOND JACOB MARROQUIN |
| Entity Type: | Individual |
| Taxonomy Code: | 1710I1003X |
| Specialty: | Military Health Care Provider |
| License Number: |
Most Important Dates
| Enumeration Date: | 09/09/2021 |
| Last Updated: | 09/09/2021 |
Provider Practice Location
2418 SUNFLOWER TER
VISTA
CA
920838037
Practice Location Phone/Fax
| Phone: | 7602079003 |
| Fax: |
Provider Mailing Location
2418 SUNFLOWER TER
VISTA
CA
920838037
Provider Mailing Phone/Fax
| Phone: | 7602079003 |
| Fax: |