Mccracken, Marjorie Frost

Mccracken, Marjorie Frost is an individual health care provider with primary practice located at 2577 Samaritan Dr Ste 815, San Jose CA 95124. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatric Gastroenterology, which is considered as her primary health care specialty. Mccracken, Marjorie Frost can be contacted via phone (408) 358-3573.

Contact Information

Primary practice address
2577 Samaritan Dr Ste 815 San Jose CA 95124
Phone: (408) 358-3573
Fax: (408) 356-2888
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatric Gastroenterology 2080P0206X G59536 California

Profile Details

NPI number 1043327570
LBN Legal business name Mccracken, Marjorie Frost
Credentials MD PHD
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 23rd, 2006
Last updated Jan 11th, 2011 - about 14 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 1043327570 NPPES
California Other 770558210 FEDERAL TAX ID
California MEDICAID 00G565360 FEDERAL TAX ID

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