Marathon Medical Group Inc

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

G76025 Issued in CA

Legal business name

MARATHON MEDICAL GROUP INC

Practice address

500 S Anaheim Hills Rd
Ste 206
Anaheim Hills, CA 92807

Phone

(714) 282-6934

Fax

(714) 282-6935

NPI assigned

Aug 14, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Donna Jo Frisch, M.D.

Title

President

Phone

(714) 282-6934

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Bernadine M Deramo, NP

  • Family Nurse Practitioner
  • Anaheim Hills, CA
  • NPI 1255344768

  Internal Medicine

  NPD
• Jerome De Vente, MD

  • Infectious Disease Physician
  • Long Beach, CA
  • NPI 1548208242
  NPD (past)

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

{
    "created_epoch": "1155513600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1353369600000",
    "number": "1366455875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 S ANAHEIM HILLS RD",
            "address_2": "STE 206",
            "city": "ANAHEIM HILLS",
            "state": "CA",
            "postal_code": "92807",
            "telephone_number": "714-282-6934",
            "fax_number": "714-282-6935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 S ANAHEIM HILLS RD",
            "address_2": "STE 206",
            "city": "ANAHEIM HILLS",
            "state": "CA",
            "postal_code": "92807",
            "telephone_number": "714-282-6934",
            "fax_number": "714-282-6935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARATHON MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-14",
        "last_updated": "2012-11-20",
        "status": "A",
        "authorized_official_last_name": "FRISCH",
        "authorized_official_first_name": "DONNA",
        "authorized_official_middle_name": "JO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "714-282-6934",
        "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": "G76025",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "W16596",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Deborah L. Hill, MD
• Jarom Partridge OD Inc
• Gary Michael Lovcik, O.D.
• Kelsey Lullo, M.A., APCC
• Marigangaiah Mahadev, MD
• Rebecca Marcia Maravilla, OD
• Rebeca Martinez-Higareda, SLPA
• Ivan P Martinez, M.D.
• Maruko Orthodontics Inc
• Suzanne Renee Molera, B.A COMM. DISORDERS

• Internal Medicine Physician in Anaheim Hills, CA
• Providers in Anaheim 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 Nov 20, 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.