MEDICARE: DR. MARCEL S FILART MD

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	207R00000X	Internal Medicine Physician	A76022	CA
2	207RG0300X	Geriatric Medicine (Internal Medicine) Physician	A76022	CA

Other Identifiers

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

General Provider Information

NPI Number	:	1396775474
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARCEL S FILART MD

Provider Business Mailing Address
First Line	:	6245 DE LONGPRE AVE
Second Line	:	FL 2
City	:	LOS ANGELES
State	:	CA
Zip	:	90028-8253
Country	:	US
Telephone Number	:	323-499-1350
Fax Number	:	323-798-3021

Provider Business Practice Location Address
First Line	:	6245 DE LONGPRE AVE
Second Line	:	FL 2
City	:	LOS ANGELES
State	:	CA
Zip	:	90028-8253
Country	:	US
Telephone Number	:	323-499-1350
Fax Number	:	323-798-3021

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

Provider Enumeration Date	:	07/04/2006
Last Update Date	:	04/29/2021

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