Provider Demographics
NPI:1649607870
Name:MARQUEZ, JONATHAN PAUL (MA)
Entity type:Individual
Prefix:MR
First Name:JONATHAN
Middle Name:PAUL
Last Name:MARQUEZ
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7021 DRAPER AVE
Mailing Address - Street 2:
Mailing Address - City:LA JOLLA
Mailing Address - State:CA
Mailing Address - Zip Code:92037-5409
Mailing Address - Country:US
Mailing Address - Phone:956-279-0039
Mailing Address - Fax:
Practice Address - Street 1:10455 POMERADO RD
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92131-1717
Practice Address - Country:US
Practice Address - Phone:956-279-0039
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-10-02
Last Update Date:2013-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist