Jeffrey Ellis Marshak, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPT 5564 TPL Issued in CA

Practice address

390 N Sepulveda Blvd
Suite# 1100
El Segundo, CA 90245-4475

Phone

(310) 641-1700

Fax

(310) 535-2155

NPI assigned

Feb 27, 2007

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326326400000",
    "number": "1225165590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "390 N SEPULVEDA BLVD",
            "address_2": "SUITE#1100",
            "city": "EL SEGUNDO",
            "state": "CA",
            "postal_code": "902454475",
            "telephone_number": "310-641-1700",
            "fax_number": "310-535-2155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "390 N SEPULVEDA BLVD",
            "address_2": "SUITE# 1100",
            "city": "EL SEGUNDO",
            "state": "CA",
            "postal_code": "902454475",
            "telephone_number": "310-641-1700",
            "fax_number": "310-535-2155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARSHAK",
        "first_name": "JEFFREY",
        "middle_name": "ELLIS",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-27",
        "last_updated": "2012-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "OPT 5564 TPL",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "5564T",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paulina Marquez
• Salma Marquez
• Michael E Marrero, M.D.
• Robert Marriott, MD
• Diana Marron
• Dante Marshall
• Lillian Marshall
• Jose Martha
• Brian A Martin
• Chloe Martin

• Optometrist in El Segundo, CA
• Providers in El Segundo, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2012; 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.