Marina Women'S Medical Group, Inc.

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

C35271 Issued in CA

Legal business name

MARINA WOMEN'S MEDICAL GROUP, INC.

Practice address

4560 Admiralty Way
303
Marina del Rey, CA 90292-5423

Phone

(310) 822-5066

Fax

(310) 827-4420

NPI assigned

Jul 20, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Dale Gene Parks, M.D.

Title

MD/Owner

Phone

(310) 822-5066

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1278979200000",
    "number": "1104846682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4560 ADMIRALTY WAY",
            "address_2": "303",
            "city": "MARINA DEL REY",
            "state": "CA",
            "postal_code": "902925423",
            "telephone_number": "310-822-5066",
            "fax_number": "310-827-4420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4560 ADMIRALTY WAY",
            "address_2": "303",
            "city": "MARINA DEL REY",
            "state": "CA",
            "postal_code": "902925423",
            "telephone_number": "310-822-5066",
            "fax_number": "310-827-4420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARINA WOMEN'S MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-20",
        "last_updated": "2010-07-13",
        "status": "A",
        "authorized_official_last_name": "PARKS",
        "authorized_official_first_name": "DALE",
        "authorized_official_middle_name": "GENE",
        "authorized_official_title_or_position": "MD/OWNER",
        "authorized_official_telephone_number": "310-822-5066",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "C35271",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00C352710",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Marina Optometry a Professional Corporation
• Marina Ortho, Inc.
• Marina Outpatient Surgery Center
• Marina Psychological Services
• Marina View Surgery Center
• Marius Saines, M.D. Professional Corp
• Mark R. Pulera, MD, a Professional Corporation
• Dontae Marshall
• Jordan Martin, MA, NCC, LPC
• Corina Martinez

• Obstetrics & Gynecology Physician in Marina del Rey, CA
• Providers in Marina del Rey, CA by specialty
• Obstetrics & Gynecology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 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.