Active NPI
Larry Marianella, MD a Professional Corp.
- Internal Medicine Physician
- Santa Rosa, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- G38835
- 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
- Last updated
- Nov 30, 2010
- 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
- Dr. Larry Marianella, M.D.
- Title
- President
- Phone
- (707) 526-4865
Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | G38835 | CA | Primary |
Addresses
Primary practice location
1515 Montgomery Dr
Santa Rosa, CA 95405-4500
Mailing address
1515 Montgomery Dr
Santa Rosa, CA 95405-4500
Phone (707) 526-4865
National Provider Directory
National Provider DirectoryLocations
1515 Montgomery Dr
Santa Rosa, CA 95405
Phone (707) 526-4865
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Internal Medicine Physician
- Santa Rosa, CA
- NPI 1144257486
NPI Registry JSON
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": [],
"endpoints": [],
"other_names": []
}
Other providers in Santa Rosa, CA
Sources for this page
- 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.