MEDICARE: MARC J. GIRSKY MD INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RC0001X	Clinical Cardiac Electrophysiology Physician	G83112	CA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P00464615	OTHER	CA	MEDICARE RAILROAD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1215921044
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARC J. GIRSKY MD INC

Provider Business Mailing Address
First Line	:	1400 S GRAND AVE
Second Line	:	SUITE 615
City	:	LOS ANGELES
State	:	CA
Zip	:	90015-3048
Country	:	US
Telephone Number	:	213-748-0110
Fax Number	:	213-748-0160

Provider Business Practice Location Address
First Line	:	1400 S GRAND AVE
Second Line	:	SUITE 615
City	:	LOS ANGELES
State	:	CA
Zip	:	90015-3048
Country	:	US
Telephone Number	:	213-748-0110
Fax Number	:	213-748-0160

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/08/2005
Last Update Date	:	03/12/2012

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