Healthcare Provider Details

I. General information

NPI: 1427071208
Provider Name (Legal Business Name): MARSHA ANN EPSTEIN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/25/2006
Last Update Date: 10/21/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

695 S VERMONT AVE SOUTH TOWER 14TH FLOOR
LOS ANGELES CA
90005-1349
US

IV. Provider business mailing address

PO BOX 642728
LOS ANGELES CA
90064-8243
US

V. Phone/Fax

Practice location:
  • Phone: 310-390-6430
  • Fax:
Mailing address:
  • Phone: 310-390-6430
  • Fax: 310-390-6430

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License NumberA23777
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: