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NPI Code Detail

MEDICARE: MARIAN GERGES

MEDICARE: MARIAN GERGES
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11835P0018XPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist81912CA

General Provider Information

NPI Number : 1346835055
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARIAN GERGES
Provider Business Mailing Address
First Line : 1500 E GAGE AVE
Second Line :
City : LOS ANGELES
State : CA
Zip : 90001-1724
Country : US
Telephone Number : 323-581-0964
Fax Number :
Provider Business Practice Location Address
First Line : 1500 E GAGE AVE
Second Line :
City : LOS ANGELES
State : CA
Zip : 90001-1724
Country : US
Telephone Number : 323-581-0964
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/04/2021
Last Update Date : 03/05/2021

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Directions to “ MARIAN GERGES ” Practice Location

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