Individual provider Active NPI

Marvin Mina, MD

  • Family Medicine Physician
  • Sylmar, CA
National Provider Identifier
1881611648
Registry record updated Mar 11, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A83059 Issued in CA
Practice address
14124 Foothill Blvd
Suite 100
Sylmar, CA 91342
Phone
(818) 367-1012
Fax
(818) 367-7570
NPI assigned
Jul 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A83059 CA Primary

Addresses

Primary practice location

14124 Foothill Blvd
Suite 100
Sylmar, CA 91342

Mailing address

14124 Foothill Blvd
Suite 100
Sylmar, CA 91342
Phone (818) 367-1012

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
I20060410000581 CA Practitioner - Family Practice 1153330766 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Loma Linda University School of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Cedars-Sinai Medical Care FoundationGroup PAC ID 0941106645, 1,684 clinicians

Practice addresses (Care Compare)

10100 Culver Blvd
Suite E
Culver City, CA 90232-3174
Phone (310) 423-3333

12746 W Jefferson Blvd
Suite 2000
Playa Vista, CA 90094-2776
Phone (424) 315-2220

8501 Wilshire Blvd
Suite 150
Beverly Hills, CA 90211-3148
Phone (310) 385-3334

8767 Wilshire Blvd
Beverly Hills, CA 90211-2714

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.14 of 100Reported as group
Quality
84.79
Promoting interoperability
99
Improvement activities
40
Cost
73.15

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A83059CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cedars-Sinai Medical Care Foundation CurrentSince Aug 1, 2010 Accepting new patients
Deanco Healthcare LLC. Past Accepting new patients
Providence Health System - Southern California Past Accepting new patients
Cedars-Sinai Medical Center Past Accepting new patients
California Care Level Management Direct Medical Group, Inc PastSince Jun 26, 2006 Accepting new patients

Locations

8767 Wilshire Blvd
Fl 2
Beverly Hills, CA 90211
Phone (310) 248-7000

10100 Culver Blvd
Ste A
Culver City, CA 90232
Phone (310) 423-3333

8635 W 3rd St
Ste 465W
Los Angeles, CA 90048
Phone (310) 423-0674

4140 W 190th St
Torrance, CA 90504
Phone (310) 967-1780

Organizations & group practices 5

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1268265600000",
    "number": "1881611648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14124 FOOTHILL BLVD",
            "address_2": "SUITE 100",
            "city": "SYLMAR",
            "state": "CA",
            "postal_code": "91342",
            "telephone_number": "818-367-1012",
            "fax_number": "818-367-7570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14124 FOOTHILL BLVD",
            "address_2": "SUITE 100",
            "city": "SYLMAR",
            "state": "CA",
            "postal_code": "91342",
            "telephone_number": "818-367-1012",
            "fax_number": "818-367-7570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINA",
        "first_name": "MARVIN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2010-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A83059",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sylmar, CA

Sources for this page

Verify at the official NPI Registry.