Organization Active NPI

SCLC North PC a Medical Group

  • Hepatology Physician
  • Garden Grove, CA
National Provider Identifier
1053230870
Registry record updated Jul 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hepatology PhysicianTaxonomy code 207RI0008X
Legal business name
SCLC NORTH PC A MEDICAL GROUP
Practice address
12665 Garden Grove Blvd Ste 304
Garden Grove, CA 92843-1917
Phone
(310) 553-5203
NPI assigned
Jul 14, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Glenn Andrew Marshak, MD
Title
Owner
Phone
(310) 553-5203

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RG0100X
Hepatology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RI0008X Primary

Addresses

Primary practice location

12665 Garden Grove Blvd Ste 304
Garden Grove, CA 92843-1917

Mailing address

8447 Wilshire Blvd
Beverly Hills, CA 90211-3226
Phone (310) 553-5203

National Provider Directory

National Provider Directory

Locations

8447 Wilshire Blvd
Beverly Hills, CA 90211

12665 Garden Grove Blvd
Ste 304
Garden Grove, CA 92843
Phone (714) 537-5302

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1783987200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1783987200000",
    "number": "1053230870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8447 WILSHIRE BLVD",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902113226",
            "telephone_number": "310-553-5203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12665 GARDEN GROVE BLVD STE 304",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928431917",
            "telephone_number": "310-553-5203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SCLC NORTH PC A MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-07-14",
        "last_updated": "2026-07-14",
        "certification_date": "2026-07-14",
        "status": "A",
        "authorized_official_last_name": "MARSHAK",
        "authorized_official_first_name": "GLENN",
        "authorized_official_middle_name": "ANDREW",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "310-553-5203",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RI0008X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Hepatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Garden Grove, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.