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General NPI Number Information
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NPI Number | 1053230870
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Entity Type | Organization
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Legal Business Name | SCLC NORTH PC A MEDICAL GROUP
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Dates
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Enumeration Date | 07/14/2026
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Last Update Date | 07/14/2026
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Provider Practice Location Address
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Address Line | 12665 GARDEN GROVE BLVD STE 304
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City | GARDEN GROVE
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State | CA
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Zip | 92843-1917
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Country | US
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Telephone | 310-553-5203
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Fax |
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Provider Business Mailing Address
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Address Line | 8447 WILSHIRE BLVD
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City | BEVERLY HILLS
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State | CA
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Zip | 90211-3226
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Country | US
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Telephone | 310-553-5203
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | GLENN ANDREW MARSHAK
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Credential | MD
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Telephone | 310-553-5203
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207RI0008X
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Taxonomy Name | Hepatology Physician
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License Number |
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License Number State |
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