Individual provider Active NPI

Marjun Philip Narciso Duldulao III, M.D.

  • Colon & Rectal Surgery Physician
  • Los Angeles, CA
National Provider Identifier
1063684850
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Colon & Rectal Surgery PhysicianTaxonomy code 208C00000X
License
A109414 Issued in CA
Practice address
1450 San Pablo Street Suite 6200
Los Angeles, CA 90089-0112
Phone
(323) 865-3690
NPI assigned
Apr 1, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Colon & Rectal Surgery Physician 208C00000X A109414 CA Primary

Addresses

Primary practice location

1450 San Pablo Street Suite 6200
Los Angeles, CA 90089-0112

Mailing address

PO Box 31309
Los Angeles, CA 90031-0309
Phone (323) 865-3690

Other names 1

  • Dr. Philip Marjun Duldulao III Other name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address marjun.duldulao@direct.usc.edu Direct USC CARE MEDICAL GROUP, INC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110415000299 CA Practitioner - Colorectal Surgery (Proctology)Practitioner - General Surgery 0941484992 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Colorectal Surgery (Proctology)Also: General Surgery
Education
New York Medical College, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Usc Care Medical Group IncGroup PAC ID 0446157747, 1,378 clinicians

Practice addresses (Care Compare)

1441 Eastlake Ave
Suite 2424
Los Angeles, CA 90089-0112
Phone (323) 442-2582

1450 San Pablo St
Los Angeles, CA 90033-4500

1500 San Pablo St
Los Angeles, CA 90033-5313
Phone (323) 442-8444

1516 San Pablo St
Los Angeles, CA 90033-5313
Phone (800) 872-2273

1520 San Pablo St
Los Angeles, CA 90033-5310
Phone (800) 872-2273

1520 San Pablo St 1St Floor N
Los Angeles, CA 90033-5310
Phone (800) 872-2273

1812 Verdugo Blvd
Glendale, CA 91208-1407
Phone (818) 790-7100

23845 McBean Pkwy
Valencia, CA 91355-2001
Phone (661) 253-8000

420 34TH St
Bakersfield, CA 93301-2298
Phone (661) 327-4647

Hospital & facility affiliations

  • Keck Hospital of Usc Hospital, Los Angeles, CA, CCN 050696
  • Henry Mayo Newhall Hospital Hospital, Valencia, CA, CCN 050624
  • Usc Verdugo Hills Hospital Hospital, Glendale, CA, CCN 050124
  • Usc Kenneth Norris Jr Cancer Hospital Hospital, Los Angeles, CA, CCN 050660

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy42
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Removal of tissue1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
109414CAMDGeneral Practice Dentistry
A109414CAMDColon & Rectal Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Usc Care Medical Group, Inc CurrentSince Jun 1, 2016 Accepting new patients
Usc Care Medical Group, Inc CurrentSince Jun 1, 2016 Accepting new patients
Lancaster Hospital Corporation Past Accepting new patients
Usc Verdugo Hills Hospital, LLC Past Accepting new patients
Usc University Hospital, Inc. Past Accepting new patients
Keck Medical Center of Usc Past Accepting new patients

Locations

420 34th St
Bakersfield, CA 93301
Phone (661) 324-4647

1808 Verdugo Blvd
Ste 208
Glendale, CA 91208
Phone (818) 952-5322

1441 Eastlake Ave
Los Angeles, CA 90089
Phone (323) 865-3000

1520 San Pablo St
Los Angeles, CA 90033
Phone (323) 442-5849

1450 San Pablo St
Ste 6200
Los Angeles, CA 90033
Phone (323) 442-7920

1450 San Pablo St
Ste HC46200
Los Angeles, CA 90033

25751 McBean Pkwy
Ste 200
Valencia, CA 91355
Phone (661) 284-3155

25751 McBean Pkwy
Ste 220
Valencia, CA 91355
Phone (661) 290-3337

Interoperability endpoints

  • Direct secure messaging: marjun.duldulao@direct.usc.edu

Organizations & group practices 6

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

Hospital & facility affiliations 4

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": "1207008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1063684850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 31309",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900310309",
            "telephone_number": "323-865-3690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1450 SAN PABLO STREET SUITE 6200",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900890112",
            "telephone_number": "323-865-3690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DULDULAO",
        "first_name": "MARJUN",
        "middle_name": "PHILIP NARCISO",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-01",
        "last_updated": "2023-11-27",
        "certification_date": "2020-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "CA",
            "license": "A109414",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "marjun.duldulao@direct.usc.edu",
            "affiliation": "Y",
            "affiliationName": "USC CARE MEDICAL GROUP, INC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1450 San Pablo Street Suite 6200",
            "city": "Los Angeles",
            "state": "CA",
            "country_code": "US",
            "postal_code": "900890112",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "PHILIP",
            "last_name": "DULDULAO",
            "middle_name": "MARJUN",
            "prefix": "DR.",
            "suffix": "III",
            "credential": "M.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.