Carl E. Marusak, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

C22226 Issued in CA

Practice address

201 S Mission Dr
Suite 116
San Gabriel, CA 91776-1164

Phone

(626) 282-5155

Fax

(626) 289-8570

NPI assigned

May 23, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1528278660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "922 RIVAS CYN",
            "city": "PACIFIC PALISADES",
            "state": "CA",
            "postal_code": "902723957"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 S MISSION DR",
            "address_2": "SUITE 116",
            "city": "SAN GABRIEL",
            "state": "CA",
            "postal_code": "917761164",
            "telephone_number": "626-282-5155",
            "fax_number": "626-289-8570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARUSAK",
        "first_name": "CARL",
        "middle_name": "E.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "C22226",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychiatry Physician in San Gabriel, CA
• Providers in San Gabriel, CA by specialty
• Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.