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NPI Code Detail

MEDICARE: MARNIE LYNN STEWART

MEDICARE: MARNIE LYNN STEWART
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
1171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1770178964
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARNIE LYNN STEWART
Provider Business Mailing Address
First Line : 1749 14TH ST
Second Line :
City : SANTA MONICA
State : CA
Zip : 90404-4342
Country : US
Telephone Number : 323-513-3076
Fax Number :
Provider Business Practice Location Address
First Line : 1749 14TH ST
Second Line :
City : SANTA MONICA
State : CA
Zip : 90404-4342
Country : US
Telephone Number : 323-513-3076
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/09/2021
Last Update Date : 03/09/2021

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Directions to “ MARNIE LYNN STEWART ” Practice Location

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