Corley, Marcus Leo

Corley, Marcus Leo is an individual health care provider with primary practice located at 555 Laurel Ave Apt 513 , San Mateo CA 94401-4153. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Diagnostic Radiology, Allopathic & Osteopathic Physicians / General Practice, Allopathic & Osteopathic Physicians / Anesthesiology. Allopathic & Osteopathic Physicians / Anesthesiology is his primary health care specialty. Corley, Marcus Leo can be contacted via phone (650) 533-4655.

Contact Information

Primary practice address
555 Laurel Ave Apt 513 San Mateo CA 94401-4153
Phone: (650) 533-4655
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X E0863 Texas
Allopathic & Osteopathic Physicians / General Practice 208D00000X C36871 California
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X E0863 Texas
Allopathic & Osteopathic Physicians / General Practice 208D00000X E0863 Texas
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X C36871 California

Profile Details

NPI number 1649211285
LBN Legal business name Corley, Marcus Leo
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 8th, 2006
Last updated Feb 22nd, 2023 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1649211285 NPPES
California Other C36871 CALIFORNIA STATE MEDICAL LICENSE
California MEDICAID 00C368710 CALIFORNIA STATE MEDICAL LICENSE
California Other E0863 CALIFORNIA STATE MEDICAL LICENSE

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