Larry Marianella, MD a Professional Corp.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

G38835 Issued in CA

Legal business name

LARRY MARIANELLA, MD A PROFESSIONAL CORP.

Practice address

1515 Montgomery Dr
Santa Rosa, CA 95405-4500

Phone

(707) 526-4865

Fax

(707) 526-5375

NPI assigned

Nov 30, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Larry Marianella, M.D.

Title

President

Phone

(707) 526-4865

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1291075200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1291075200000",
    "number": "1104128941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 MONTGOMERY DR",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954054500",
            "telephone_number": "707-526-4865",
            "fax_number": "707-526-5375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 MONTGOMERY DR",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954054500",
            "telephone_number": "707-526-4865",
            "fax_number": "707-526-5375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LARRY MARIANELLA, MD A PROFESSIONAL CORP.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-30",
        "last_updated": "2010-11-30",
        "status": "A",
        "authorized_official_last_name": "MARIANELLA",
        "authorized_official_first_name": "LARRY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "707-526-4865",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "G38835",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G388351",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Maria Stephanie Larios
• Conrad E. Larkin, L.C.S.W.
• Emily Marie Larkin
• Evgenia Larkin
• Larry a Smith
• Makenna Mary Larsen
• Paul R Larsen
• Jennifer Larson, RPH
• Kathryn Dianne Larson, P.T.
• Nichole Larson

• Internal Medicine Physician in Santa Rosa, CA
• Providers in Santa Rosa, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2010; 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.