1689780033 NPI number — THE MARLOWE INSTITUTE

Table of content: (NPI 1689780033)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1689780033 NPI number — THE MARLOWE INSTITUTE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
THE MARLOWE INSTITUTE
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:
1689780033
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/29/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
28049 SMYTH DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
VALENCIA
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
91355-4023
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
818-906-6900
Provider Business Mailing Address Fax Number:
818-906-6903

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
15477 VENTURA BLVD
Provider Second Line Business Practice Location Address:
SUITE 100
Provider Business Practice Location Address City Name:
SHERMAN OAKS
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91403-3006
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
818-906-6900
Provider Business Practice Location Address Fax Number:
818-906-6903
Provider Enumeration Date:
08/21/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
MARLOWE
Authorized Official First Name:
EVAN
Authorized Official Middle Name:
S
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
818-906-6900

Provider Taxonomy Codes

  • Taxonomy code: 2081S0010X , with the licence number:  A067389 , 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)