Marko Michael Mamic, D.O.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

20A12620 Issued in CA

Practice address

400 N Pepper Ave
Colton, CA 92324-1801

Phone

(909) 580-1000

NPI assigned

Jan 17, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Capital Hospitalist Medical Group Inc

  • Emergency Medicine Physician
  • Los Angeles, CA
  • NPI 1992178222
  Medicare reassignment NPD
• Cep America - California

  • Emergency Medicine Physician
  • San Francisco, CA
  • NPI 1023063542
  Medicare reassignment NPD
• Cep America - California

  • Emergency Medicine Physician
  • Santa Ana, CA
  • NPI 1548667843
  Medicare reassignment NPD
• Healthcare Partners Affiliates Medical Group

  • Internal Medicine Physician
  • Los Angeles, CA
  • NPI 1659312593
  Medicare reassignment NPD
• Montclair Emergency Medical Associates

  • Emergency Medicine Physician
  • Montclair, CA
  • NPI 1316044696
  Medicare reassignment NPD
• Pih Health Physicians

  • Family Medicine Physician
  • Whittier, CA
  • NPI 1609233899
  Medicare reassignment NPD
• Vep MLK Emergency Medical Group Inc

  • Emergency Medicine Physician
  • Los Angeles, CA
  • NPI 1841679289
  Medicare reassignment NPD
• Bright Health Physicians of Pih

  • Obstetrics & Gynecology Physician
  • Whittier, CA
  • NPI 1134373871
  NPD
• Cep America - California

  • Emergency Medicine Physician
  • Montebello, CA
  • NPI 1396971651
  NPD
• Cep America - California

  • Emergency Medicine Physician
  • San Bernardino, CA
  • NPI 1508811035
  NPD
• Cep America-California

  • Emergency Medicine Physician
  • Murrieta, CA
  • NPI 1588552848
  NPD
• Healthcare Partners Affiliates Medical Group

  • Durable Medical Equipment & Medical Supplies
  • Murrieta, CA
  • NPI 1760057269
  NPD

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

{
    "created_epoch": "1326758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1399420800000",
    "number": "1104197565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "228 N PROSPECTORS RD",
            "city": "DIAMOND BAR",
            "state": "CA",
            "postal_code": "917651548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 N PEPPER AVE",
            "city": "COLTON",
            "state": "CA",
            "postal_code": "923241801",
            "telephone_number": "909-580-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAMIC",
        "first_name": "MARKO",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-01-17",
        "last_updated": "2014-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "20A12620",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aldin Malkoc, MD
• Anil D Mall, M.D.
• Claire Elizabeth Malley, MD
• Mallu Reddy, MD, Inc
• Jessica Lee Malstrom
• Benjamin Morales Manacop III
• Amir Manafi, MD
• Sharan Kaur Mangat
• Navdeep Singh Manhas
• Jeannette Maniago

• Emergency Medicine Physician in Colton, CA
• Providers in Colton, CA by specialty
• Emergency Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.