Individual provider Active NPI

George Leonard Marks, MD

  • Internal Medicine Physician
  • Los Angeles, CA
National Provider Identifier
1578589602
Registry record updated Jun 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
C39879 Issued in CA
Practice address
866 N Vermont Ave Ste 3
Los Angeles, CA 90029-3587
Phone
(323) 906-0050
Fax
(323) 906-0060
NPI assigned
Jul 14, 2006
Last updated
Jun 20, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 20, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X C39879 CA Primary

Addresses

Primary practice location

866 N Vermont Ave Ste 3
Los Angeles, CA 90029-3587

Mailing address

866 N Vermont Ave Ste 3
Los Angeles, CA 90029-3587
Phone (323) 906-0050

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041206001043 CA Practitioner - Internal MedicinePractitioner - Cardiovascular Disease (Cardiology) 6800852344 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Cardiovascular Disease (Cardiology)
Education
Perelman School of Med at the University of Pennsylvania, 1976
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1670 E 120TH St
Los Angeles, CA 90059-3026

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
C39879CAMDInternal Medicine Physician

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308528000000",
    "number": "1578589602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "866 N VERMONT AVE STE 3",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900293587",
            "telephone_number": "323-906-0050",
            "fax_number": "323-906-0060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "866 N VERMONT AVE STE 3",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900293587",
            "telephone_number": "323-906-0050",
            "fax_number": "323-906-0060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARKS",
        "first_name": "GEORGE",
        "middle_name": "LEONARD",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-14",
        "last_updated": "2011-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "C39879",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.