Healthcare Provider Details

I. General information

NPI: 1528260825
Provider Name (Legal Business Name): MARILYN LI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/31/2007
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 N ROBERTSON BLVD STE 501
BEVERLY HILLS CA
90211-1770
US

IV. Provider business mailing address

PO BOX 31309
LOS ANGELES CA
90031-0309
US

V. Phone/Fax

Practice location:
  • Phone: 310-423-3040
  • Fax:
Mailing address:
  • Phone: 323-442-5100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License NumberA64596
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: