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General NPI Number Information
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NPI Number | 1063491918
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Entity Type | Individual
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Provider Name | MARC JENNINGS MORSE M.D.
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Gender | Male
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Dates
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Enumeration Date | 01/10/2006
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Last Update Date | 10/01/2019
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Provider Practice Location Address
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Address Line | 2701 OCEAN PARK BLVD STE 130
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City | SANTA MONICA
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State | CA
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Zip | 90405
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Country | US
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Telephone | 310-450-1200
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Fax | 310-450-8830
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Provider Business Mailing Address
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Address Line | 5767 W CENTURY BLVD STE 400
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City | LOS ANGELES
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State | CA
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Zip | 90045-5631
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | G162875
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License Number State | CA
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