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NPI 1093634479

NPI 1093634479 : MARIAN FAMILY CLINIC A PROFESSIONAL CORPORATION : SAN GABRIEL, CA

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General NPI Number Information
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    NPI Number           |    1093634479
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    Entity Type          |    Organization 
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    Legal Business Name  |    MARIAN FAMILY CLINIC A PROFESSIONAL CORPORATION 
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Dates
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    Enumeration Date     |    07/10/2026
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    Last Update Date     |    07/10/2026
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Provider Practice Location Address
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    Address Line         |    416 W LAS TUNAS DR STE 102 
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    City                 |    SAN GABRIEL
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    State                |    CA
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    Zip                  |    91776-1236
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    Country              |    US
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    Telephone            |    626-285-9705
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    416 W LAS TUNAS DR STE 102 
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    City                 |    SAN GABRIEL
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    State                |    CA
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    Zip                  |    91776-1236
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    Country              |    US
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    Telephone            |    626-285-9705
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    Fax                  |    
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Authorized Official
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    Title or Position    |    CEO
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    Name                 |     SHARY  JOSEPH 
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    Credential           |    
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    Telephone            |    562-832-7792
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    207R00000X
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    Taxonomy Name        |    Internal Medicine Physician
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    License Number       |    
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    License Number State |    
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