1477987063 NPI number — MARCEL S. FILART, MD, INC

Table of content: (NPI 1477987063)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1477987063 NPI number — MARCEL S. FILART, MD, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MARCEL S. FILART, MD, INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1477987063
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/30/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3755 BEVERLY BLVD
Provider Second Line Business Mailing Address:
STE 300
Provider Business Mailing Address City Name:
LOS ANGELES
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
90004-3539
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
323-664-4234
Provider Business Mailing Address Fax Number:
323-664-4235

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3755 BEVERLY BLVD
Provider Second Line Business Practice Location Address:
STE 300
Provider Business Practice Location Address City Name:
LOS ANGELES
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90004-3539
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
323-664-4234
Provider Business Practice Location Address Fax Number:
323-664-4235
Provider Enumeration Date:
08/30/2013

Additional Information

Authorized Official

Authorized Official Last Name:
FILART
Authorized Official First Name:
MARCEL
Authorized Official Middle Name:
S
Authorized Official Title or Position:
MD, OWNER
Authorized Official Telephone Number:
323-664-4234

Provider Taxonomy Codes

  • Taxonomy code: 207RG0300X , with the licence number:  A76022 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: A76022 . This is a "CA LICENSE" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".




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