NPIMap

Organization Active NPI

Marian a. Fedak M.D. Medical Corporation

Doing business as VMV Medical Associates, Inc.

  • Specialist
  • Los Angeles, CA
National Provider Identifier
1619077138
Registry record updated Feb 24, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
G186240 Issued in CA
Legal business name
MARIAN A. FEDAK M.D. MEDICAL CORPORATION
Doing business as
VMV Medical Associates, Inc.
Practice address
1700 E Cesar E Chavez Ave
Suite 3300
Los Angeles, CA 90033-2424
Phone
(323) 264-4114
NPI assigned
Sep 24, 2006
Last updated
Feb 24, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2010

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

Authorized official

Name
Marian A. Fedak, M.D.NPI 1245313683
Title
President/Physician
Phone
(323) 264-4114

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X G186240 CA Primary

Addresses

Primary practice location

1700 E Cesar E Chavez Ave
Suite 3300
Los Angeles, CA 90033-2424

Mailing address

PO Box 6865
San Pedro, CA 90734-6865

Other identifiers 2

IdentifierTypeStateIssuer
GR0077680MedicaidCA
00G186240MedicaidCA

Other names 1

  • VMV Medical Associates, Inc. Doing business as

National Provider Directory

National Provider Directory

Locations

1700 E Cesar E Chavez Ave
#L
Los Angeles, CA 90033
Phone (323) 307-8900

1700 E Cesar E Chavez Ave
#L275
Los Angeles, CA 90033
Phone (323) 307-8900

1720 E Cesar E Chavez Ave
Ste ZG270
Los Angeles, CA 90033
Phone (323) 260-5880

Practitioners & affiliated clinicians

Practitioners 14

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1159056000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1266969600000",
    "number": "1619077138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6865",
            "city": "SAN PEDRO",
            "state": "CA",
            "postal_code": "907346865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 E CESAR E CHAVEZ AVE",
            "address_2": "SUITE 3300",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900332424",
            "telephone_number": "323-264-4114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARIAN A. FEDAK M.D. MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-24",
        "last_updated": "2010-02-24",
        "status": "A",
        "authorized_official_last_name": "FEDAK",
        "authorized_official_first_name": "MARIAN",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "PRESIDENT/PHYSICIAN",
        "authorized_official_telephone_number": "323-264-4114",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "G186240",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0077680",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G186240",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "VMV Medical Associates, Inc.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Feb 24, 2010; 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.