Marshall Roy Koon, PA-C
Physician Assistant, Medical in Apple Valley, CA. Individual provider (NPI-1).
NPI number1982939302
StatusActive
Last updated in NPPESOct 4, 2009
Details
- NPI
- 1982939302
- Entity type
- Individual (NPI-1)
- Name
- Marshall Roy Koon
- Credential
- PA-C
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Oct 4, 2009
- Last updated
- Oct 4, 2009
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363AM0700X | Physician Assistant, Medical | PA20578 | CA | Yes |
Practice location
18300 Us Highway 18Apple Valley, CA 92307-2206
Phone 760-242-2311
Mailing address
18300 Us Highway 18Apple Valley, CA 92307-2206
Phone 760-242-2311
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