Active NPI
SCLC North PC a Medical Group
- Hepatology Physician
- Garden Grove, CA
National Provider Identifier
1053230870
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hepatology Physician
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Gastroenterology Physician | 207RG0100X | |||
| Hepatology Physician | 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 DirectoryLocations
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.