Active NPI
Marilyn Bravo
- Emergency Medicine Physician
- Los Angeles, CA
National Provider Identifier
1386446326
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- 19587
- Practice address
- 2051 Marengo St
Los Angeles, CA 90033-1352 - Phone
- (323) 409-7053
- NPI assigned
- Mar 27, 2025
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 19587 | CA | Primary |
Addresses
Primary practice location
2051 Marengo St
Los Angeles, CA 90033-1352
Mailing address
2051 Marengo St
Los Angeles, CA 90033-1352
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250819001296 | CA | Order and Referring Only - Emergency Medicine | 5799284584 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 19587 | CA | MD | Emergency Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1743033600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1776297600000",
"number": "1386446326",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2051 MARENGO ST",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900331352"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2051 MARENGO ST",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900331352",
"telephone_number": "323-409-7053"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRAVO",
"first_name": "MARILYN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2025-03-27",
"last_updated": "2026-04-16",
"certification_date": "2026-04-16",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "CA",
"license": "19587",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2026; 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.