Individual provider Active NPI

Isagani Ignacio Marquez Jr.

  • Family Nurse Practitioner
  • Eastvale, CA
National Provider Identifier
1104706407
Registry record updated Sep 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F11240448 Issued in CA
Practice address
6615 Canter Cove CT
Eastvale, CA 92880-3722
Phone
(909) 255-5348
NPI assigned
Sep 5, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F11240448 CA Primary

Addresses

Primary practice location

6615 Canter Cove CT
Eastvale, CA 92880-3722

Mailing address

6615 Canter Cove CT
Eastvale, CA 92880-3722
Phone (909) 255-5348

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

450 N Brand Blvd
Suite 600
Glendale, CA 91203-2349

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
F11240448CAMDFamily Nurse Practitioner

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1757030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757030400000",
    "number": "1104706407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6615 CANTER COVE CT",
            "city": "EASTVALE",
            "state": "CA",
            "postal_code": "928803722",
            "telephone_number": "909-255-5348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6615 CANTER COVE CT",
            "city": "EASTVALE",
            "state": "CA",
            "postal_code": "928803722",
            "telephone_number": "909-255-5348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARQUEZ",
        "first_name": "ISAGANI",
        "middle_name": "IGNACIO",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-09-05",
        "last_updated": "2025-09-05",
        "certification_date": "2025-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "F11240448",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eastvale, CA

Sources for this page

Verify at the official NPI Registry.