=====================================================
General NPI Number Information
=====================================================
NPI Number | 1316944978
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MARIUS SAINES MD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/28/2005
-----------------------------------------------------
Last Update Date | 04/24/2014
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 575 E HARDY ST STE 322
-----------------------------------------------------
City | INGLEWOOD
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90301-4036
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 310-673-6950
-----------------------------------------------------
Fax | 310-671-9989
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 575 E HARDY ST STE 322
-----------------------------------------------------
City | INGLEWOOD
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90301-4036
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 310-673-6950
-----------------------------------------------------
Fax | 310-671-9989
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2086S0129X
-----------------------------------------------------
Taxonomy Name | Vascular Surgery Physician
-----------------------------------------------------
License Number | A36390
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------