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General NPI Number Information
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NPI Number | 1639674161
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Entity Type | Organization
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Legal Business Name | DAVID MARCUS MD, INC.
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Dates
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Enumeration Date | 03/27/2018
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Last Update Date | 03/27/2018
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Provider Practice Location Address
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Address Line | 107 S. FAIR OAKS AVENUE SUITE #315
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City | PASADENA
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State | CA
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Zip | 91105
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Country | US
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Telephone | 626-219-6657
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Fax | 626-219-6658
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Provider Business Mailing Address
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Address Line | 10573 W. PICO BLVD P.O. BOX 338
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City | LOS ANGELES
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State | CA
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Zip | 90064
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Country | US
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Telephone | 626-219-6657
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Fax | 626-219-6658
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Authorized Official
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Title or Position | OWNER
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Name | MR. DAVID LOREN MARCUS
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Credential | M.D.
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Telephone | 310-702-7124
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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