Active NPI
Gail Marks, MD
- Pediatrics Physician
- San Bernardino, CA
National Provider Identifier
1700813698
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- G45659
- Practice address
- 350 E Vanderbilt Way
Ste B
San Bernardino, CA 92408 - Phone
- (909) 886-1001
- Fax
- (909) 886-1107
- NPI assigned
- Jun 27, 2006
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | G45659 | CA | Primary |
Addresses
Primary practice location
350 E Vanderbilt Way
Ste B
San Bernardino, CA 92408
Mailing address
350 E Vanderbilt Way
Ste B
San Bernardino, CA 92408
Phone (909) 886-1001
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00G456590 | Other | CA | MEDI CAL |
| 00G456590 | Medicaid | CA | |
| P01282954/DU4034 | Other | CA | RAILROAD MEDICARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 45659 | CA | MD | Pharmacist |
| G45659 | CA | MD | Pediatrics Physician |
Practice roles (2 of 3)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Apex Pediatrics Inc | Pediatrics | Past | Accepting new patients |
| Pediatric Cardiology Specialists Medical Group Inc | Past | Accepting new patients |
Networks
- BSC 65 PLUS INDIVIDUAL MAPD
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Pediatric Cardiology Physician
- San Bernardino, CA
- NPI 1356541429
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151366400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1552608000000",
"number": "1700813698",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "350 E VANDERBILT WAY",
"address_2": "STE B",
"city": "SAN BERNARDINO",
"state": "CA",
"postal_code": "92408",
"telephone_number": "909-886-1001",
"fax_number": "909-886-1107"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "350 E VANDERBILT WAY",
"address_2": "STE B",
"city": "SAN BERNARDINO",
"state": "CA",
"postal_code": "92408",
"telephone_number": "909-886-1001",
"fax_number": "909-886-1107"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARKS",
"first_name": "GAIL",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-27",
"last_updated": "2019-03-15",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "CA",
"license": "G45659",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDI CAL",
"identifier": "00G456590",
"state": "CA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00G456590",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P01282954/DU4034",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in San Bernardino, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.