NPIMap

Individual provider Active NPI

Marielle Celis Bolano, MD

  • Geriatric Medicine (Internal Medicine) Physician
  • Brisbane, CA
National Provider Identifier
1053766196
Registry record updated May 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
License
A166900 Issued in CA
Practice address
8000 Marina Blvd FL 8
Brisbane, CA 94005-1844
Phone
(415) 514-3577
NPI assigned
Apr 26, 2016
Last updated
May 21, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X A166900 CA Primary

Addresses

Primary practice location

8000 Marina Blvd FL 8
Brisbane, CA 94005-1844

Mailing address

File 57326
Los Angeles, CA 90074-7326

Other practice location 1

8899 University Center Ln
San Diego, CA 92122-1013
Phone (800) 926-8273

Other practice location 2

200 W Arbor Dr
San Diego, CA 92103-9000
Phone (800) 926-8273

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210518000739 CA Practitioner - Geriatric MedicinePractitioner - HospitalistPractitioner - Hospice/Palliative CarePractitioner - Internal Medicine 7416366794 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Geriatric MedicineAlso: Hospice/Palliative Care
Education
University of California, Davis School of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

490 Illinoi St 6TH Floor RM
600A 6TH Floor
San Francisco, CA 94143

490 Illinois St
FL 6
San Francisco, CA 94143-2510

8000 Marina Blvd
FL 8
Brisbane, CA 94005-1844

File
Suite 57326
Los Angeles, CA 90074

File
Suite 57326
Los Angeles, CA 90074-7326

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.77 of 100Reported as group
Quality
84.13
Promoting interoperability
100
Improvement activities
40
Cost
73.88

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A166900CAMDGeriatric Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of California Current Accepting new patients
Regents of the University of California Internal Medicine CurrentSince Jul 7, 2024 Accepting new patients
Regents of the University of California CurrentSince Jul 7, 2024 Accepting new patients
Regents of the University of California Ucsd Head and Neck Surgery Past Accepting new patients

Locations

File 57326
Los Angeles, CA 90074

200 W Arbor Dr
San Diego, CA 92103
Phone (619) 543-5754

8899 University Center Ln
San Diego, CA 92122
Phone (858) 543-7496

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1461628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779321600000",
    "number": "1053766196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "FILE 57326",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900747326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8000 MARINA BLVD FL 8",
            "city": "BRISBANE",
            "state": "CA",
            "postal_code": "940051844",
            "telephone_number": "415-514-3577"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8899 University Center Ln",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921221013",
            "country_code": "US",
            "telephone_number": "800-926-8273",
            "fax_number": "888-539-8781",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "200 W Arbor Dr",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921039000",
            "country_code": "US",
            "telephone_number": "800-926-8273",
            "fax_number": "888-539-8781",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOLANO",
        "first_name": "MARIELLE",
        "middle_name": "CELIS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-26",
        "last_updated": "2026-05-21",
        "certification_date": "2026-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "CA",
            "license": "A166900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brisbane, CA

Sources for this page

Verify at the official NPI Registry.