Provider Demographics
NPI:1548290786
Name:CORDERO, MARLENE M (MD)
Entity type:Individual
Prefix:DR
First Name:MARLENE
Middle Name:M
Last Name:CORDERO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:350 POSADA LN
Mailing Address - Street 2:SUITE 203
Mailing Address - City:TEMPLETON
Mailing Address - State:CA
Mailing Address - Zip Code:93465-4059
Mailing Address - Country:US
Mailing Address - Phone:805-434-5013
Mailing Address - Fax:805-434-5014
Practice Address - Street 1:350 POSADA LN
Practice Address - Street 2:SUITE 203
Practice Address - City:TEMPLETON
Practice Address - State:CA
Practice Address - Zip Code:93465-4059
Practice Address - Country:US
Practice Address - Phone:805-434-5013
Practice Address - Fax:805-434-5014
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-04
Last Update Date:2010-06-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA39491174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist