Provider Demographics
NPI:1437249380
Name:FIELD, MARSHALL (OD)
Entity type:Individual
Prefix:DR
First Name:MARSHALL
Middle Name:
Last Name:FIELD
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:MARSHALL
Other - Middle Name:L
Other - Last Name:FIELD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OD
Mailing Address - Street 1:19636 SHERMAN WAY
Mailing Address - Street 2:
Mailing Address - City:RESEDA
Mailing Address - State:CA
Mailing Address - Zip Code:91335-3647
Mailing Address - Country:US
Mailing Address - Phone:818-774-2020
Mailing Address - Fax:818-774-2021
Practice Address - Street 1:19636 SHERMAN WAY
Practice Address - Street 2:
Practice Address - City:RESEDA
Practice Address - State:CA
Practice Address - Zip Code:91335-3647
Practice Address - Country:US
Practice Address - Phone:818-774-2020
Practice Address - Fax:818-774-2021
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-13
Last Update Date:2025-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOPT00004644T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CASD0046440Medicaid
CA11839373OtherCAQH
CASD0046440Medicaid
CA0440800001Medicare NSC