Provider Demographics
NPI:1730996828
Name:MARASIGAN, JOHN (LMT, CMT)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:
Last Name:MARASIGAN
Suffix:
Gender:M
Credentials:LMT, CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39 CLUB CIRCLE DR
Mailing Address - Street 2:
Mailing Address - City:PALM SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:92264-6417
Mailing Address - Country:US
Mailing Address - Phone:323-739-4566
Mailing Address - Fax:
Practice Address - Street 1:39 CLUB CIRCLE DR
Practice Address - Street 2:
Practice Address - City:PALM SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:92264-6417
Practice Address - Country:US
Practice Address - Phone:323-739-4566
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-12
Last Update Date:2024-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015870225700000X
CA550225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist