Search › California › 103TC0700X
Marco Pantoja
NPI 1497034854 · on the registry since 2011 · sole proprietor
Practice
- Address
- 900 Quebec Ave
Corcoran, CA 93212 - Phone
- (559) 747-3984
- Fax
- (559) 992-7100
- Organisation at this address
- Daybreak Health
Corrections And Rehabilitation-Headquarters
California Department Of Corrections And Rehabiliations
California Substance Abuse Treatment Facility-State PrisonInferred from a shared address, not stated in the registry. - Clinicians at this address
- 74
Registry record
- Primary taxonomy
- 103TC0700X
103TC0700X
- Also registered as
- 101Y00000X
390200000X - Licence states on file
- CA
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2026-01-14
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in California