Marc D Wishingrad MD Inc

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

G69602 Issued in CA

Legal business name

MARC D WISHINGRAD MD INC

Practice address

2001 Santa Monica Blvd
Suite 360W
Santa Monica, CA 90404-2102

Phone

(310) 453-1871

Fax

(310) 453-3910

NPI assigned

Aug 30, 2006

Last updated

Nov 30, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Marc D Wishingrad, MDNPI 1093764359

Title

Physician

Phone

(310) 453-1871

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

Practitioners 1

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.

• Marc David Wishingrad, MD

  • Gastroenterology Physician
  • Santa Monica, CA
  • NPI 1093764359
  NPD (past) Authorized official

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196380800000",
    "number": "1871603092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 SANTA MONICA BLVD",
            "address_2": "SUITE 360W",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904042102",
            "telephone_number": "310-453-1871",
            "fax_number": "310-453-3910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 SANTA MONICA BLVD",
            "address_2": "SUITE 360W",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904042102",
            "telephone_number": "310-453-1871",
            "fax_number": "310-453-3910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARC D WISHINGRAD MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-30",
        "last_updated": "2007-11-30",
        "status": "A",
        "authorized_official_last_name": "WISHINGRAD",
        "authorized_official_first_name": "MARC",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "310-453-1871",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "CA",
            "license": "G69602",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G696020",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "W19685",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michelle Victoria Manzo
• Jetrina Sabado Maque
• Glenda Maramba, L.AC.
• Nilofar Marashi
• Denise Maratos
• Marc D. Chalet, MD, Inc.
• Daniella Marcellus
• Michelle March-Osoria, M.S., CCC-SLP
• Jade Alexa Renee March
• Minka Marcom-Rehwald, M.A.

• Gastroenterology Physician in Santa Monica, CA
• Providers in Santa Monica, CA by specialty
• Gastroenterology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 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.