Etkin, Marc Leonard
Etkin, Marc Leonard is an individual health care provider with primary practice located at 3020 Childrens Way , San Diego CA 92123-4223. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Pediatric Emergency Medicine. Allopathic & Osteopathic Physicians / Pediatrics is his primary health care specialty. Etkin, Marc Leonard can be contacted via phone (858) 966-8036.Contact Information
Primary practice address
3020 Childrens Way
San Diego CA 92123-4223
Phone: (858) 966-8036
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | A75092 | California |
| Allopathic & Osteopathic Physicians / Pediatric Emergency Medicine | 2080P0204X | A75092 | California |
Profile Details
| NPI number | 1194896852 |
|---|---|
| LBN Legal business name | Etkin, Marc Leonard |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 13th, 2006 |
| Last updated | Jul 8th, 2007 - about 19 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1194896852 | NPPES |
| California | MEDICAID | 00A750920 |
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