Philip Gordon Marais

Primary specialty

DentistTaxonomy code 122300000X

License

27333 Issued in CA

Practice address

1955 Lake Ave
Altadena, CA 91001-3037

Phone

(626) 585-9544

Fax

(626) 449-4932

NPI assigned

Feb 10, 2014

Sex

Male

Sole proprietor

No

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

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1391990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1391990400000",
    "number": "1851715924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1955 LAKE AVE",
            "city": "ALTADENA",
            "state": "CA",
            "postal_code": "910013037",
            "telephone_number": "626-585-9544",
            "fax_number": "626-449-4932"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1955 LAKE AVE",
            "city": "ALTADENA",
            "state": "CA",
            "postal_code": "910013037",
            "telephone_number": "626-585-9544",
            "fax_number": "626-449-4932"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARAIS",
        "first_name": "PHILIP",
        "middle_name": "GORDON",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-02-10",
        "last_updated": "2014-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "27333",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cristina T Magana, LVN
• Victoria Magdaleno
• Man Young Jung
• Joseph Manafa
• Manatee Care
• Marisol Martinez, D.C., Chiropractic Inc.
• Antonio Harvey Martin
• Cynthia Martin
• Gladis Rocio Martin
• Sheila M. Martin, MFT

• Dentist in Altadena, CA
• Providers in Altadena, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2014; 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.

Verify at the official NPI Registry.