Provider Demographics
NPI:1538424676
Name:TALISMAN, MARC ZOLLA (MD)
Entity type:Individual
Prefix:
First Name:MARC
Middle Name:ZOLLA
Last Name:TALISMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43794 OAK DR
Mailing Address - Street 2:
Mailing Address - City:THREE RIVERS
Mailing Address - State:CA
Mailing Address - Zip Code:93271-9779
Mailing Address - Country:US
Mailing Address - Phone:559-561-6805
Mailing Address - Fax:
Practice Address - Street 1:900 QUEBEC AVE
Practice Address - Street 2:
Practice Address - City:CORCORAN
Practice Address - State:CA
Practice Address - Zip Code:93212-9715
Practice Address - Country:US
Practice Address - Phone:559-992-7100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-04
Last Update Date:2012-07-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA24315261QP2400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2400XAmbulatory Health Care FacilitiesClinic/CenterPrison Health