Most Relevant Information
Provider Data
| NPI Number: | 1003643537 |
| Provider Name: | MARQUAN THOMAS |
| Entity Type: | Individual |
| Taxonomy Code: | 172V00000X |
| Specialty: | Community Health Worker |
| License Number: |
Most Important Dates
| Enumeration Date: | 09/18/2024 |
| Last Updated: | 09/18/2024 |
Provider Practice Location
11175 AZUSA CT STE 110
RANCHO CUCAMONGA
CA
917304933
Practice Location Phone/Fax
| Phone: | 6264691158 |
| Fax: |
Provider Mailing Location
10808 FOOTHILL BLVD # 160-154
RANCHO CUCAMONGA
CA
917303889
Provider Mailing Phone/Fax
| Phone: | 6264691158 |
| Fax: |