Marly Abutin
Individual provider Active NPI Registered Nurse · San Diego, CA
NPI 1407683030 · NPPES record last updated Sep 17, 2024
Key facts
- NPI
- 1407683030
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Nurse 163W00000X
- License
- 95389980 (CA)
- Practice address
- 4309 3Rd Ave
San Diego, CA 92103-1407 - Phone
- (619) 876-4502
- NPI assigned
- Sep 17, 2024
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 95389980 | CA | MD | Registered Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 95389980 | CA | Yes |
Addresses
Primary practice location
4309 3Rd Ave
San Diego, CA 92103-1407
Mailing address
10632 Stony Ridge Way
San Diego, CA 92131-6140
Other providers in San Diego, CA
- Giovanni Abundis Rodriguez
- Rawiya S Aburas
- Rola Abushaban
- Albert Abutin
- Kloie Abutin
- Rona Abutin
- Joshua Rillo Abuyo
- Katelyn Aby
- Parinaz Abyari
- Academy Medical Equipment Inc.
All providers in San Diego, CA · Registered Nurse in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 17, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.