Marwan Edris MD a Professional Corporation

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

MARWAN EDRIS MD A PROFESSIONAL CORPORATION

Practice address

25283 Cabot Rd Ste 106
Suite 106
Laguna Hills, CA 92653-5509

Phone

(949) 364-9080

Fax

(949) 364-3856

NPI assigned

Jul 9, 2006

Last updated

May 1, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Marwan Edris, M.D.NPI 1013045970

Title

Owner/Physician

Phone

(949) 364-9080

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Networks

• BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Practitioners 2

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.

• Marwan Edris, M.D.

  • Internal Medicine Physician
  • Laguna Hills, CA
  • NPI 1013045970
  Medicare reassignment Care Compare group NPD Authorized official
• Sami Edris, MD

  • Internal Medicine Physician
  • Downey, CA
  • NPI 1285194530
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1152403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714521600000",
    "number": "1205869427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25283 CABOT RD STE 106",
            "address_2": "SUITE 106",
            "city": "LAGUNA HILLS",
            "state": "CA",
            "postal_code": "926535509",
            "telephone_number": "949-364-9080",
            "fax_number": "949-364-3856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25283 CABOT RD STE 106",
            "address_2": "SUITE 106",
            "city": "LAGUNA HILLS",
            "state": "CA",
            "postal_code": "926535509",
            "telephone_number": "949-364-9080",
            "fax_number": "949-364-3856"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARWAN EDRIS MD A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-09",
        "last_updated": "2024-05-01",
        "certification_date": "2024-05-01",
        "status": "A",
        "authorized_official_last_name": "EDRIS",
        "authorized_official_first_name": "MARWAN",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "949-364-9080",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "A42896",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID NUMBER",
            "identifier": "W16626",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ilse Martinez Espinosa
• Cecilia Alexandra Martinez, LCSW
• Christian Martinez
• Israel Panlaqui Martinez, RN
• Leonel Martinez
• Sadaf Marzban Sarnaghi
• Mashealth Inc
• Masih Rezaei Dental Corporation (Pearl32 Dentistry and Wellness)
• Angela Faye Masino
• Farzad Massoudi, M.D.

• Internal Medicine Physician in Laguna Hills, CA
• Providers in Laguna Hills, 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 May 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.