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General NPI Number Information
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NPI Number | 1093710345
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Entity Type | Individual
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Provider Name | MARK L GELLER M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/14/2005
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Last Update Date | 10/23/2018
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Provider Practice Location Address
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Address Line | 18133 VENTURA BLVD SUITE 204
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City | TARZANA
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State | CA
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Zip | 91356-3641
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Country | US
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Telephone | 818-466-7700
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Fax | 818-996-1649
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Provider Business Mailing Address
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Address Line | PO BOX 9602
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City | MISSION HILLS
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State | CA
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Zip | 91346-9602
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Country | US
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Telephone | 818-837-5559
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Fax | 818-792-4793
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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 | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | G60287
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License Number State | CA
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