Individual provider Active NPI

Marian Fam, MD

  • Family Medicine Physician
  • Cleveland, OH
National Provider Identifier
1891291423
Registry record updated Jul 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A174623 Issued in CA
Practice address
3569 Ridge Rd
Cleveland, OH 44102-5443
Phone
(216) 281-0872
Fax
(216) 961-5429
NPI assigned
Apr 3, 2018
Reactivated
Mar 22, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 10, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X A174623 CA Primary

Addresses

Primary practice location

3569 Ridge Rd
Cleveland, OH 44102-5443

Mailing address

PO Box 72674
Cleveland, OH 44192-0002
Phone (216) 281-0872

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
I20220512002462 CA Practitioner - Family Practice 7618354622 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
United Medical Doctors Single Specialty CurrentSince Mar 1, 2022 Accepting new patients
United Medical Doctors Single Specialty CurrentSince Mar 1, 2022 Accepting new patients

Locations

2083 Compton Ave
Ste 104
Corona, CA 92881
Phone (951) 256-8191

521 E Elder St
Ste 104
Fallbrook, CA 92028
Phone (760) 728-9560

28078 Baxter Rd
Ste 530
Murrieta, CA 92563
Phone (951) 290-5472

400 Newport Center Dr
Ste 609
Newport Beach, CA 92660
Phone (949) 760-0398

4244 Riverwalk Pkwy
Ste 290
Riverside, CA 92505
Phone (833) 863-3627

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/9170/brand/1/csg/1/fhir/r4

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.

NPI Registry JSON

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

{
    "created_epoch": "1522713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783641600000",
    "number": "1891291423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 72674",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441920002",
            "telephone_number": "216-281-0872",
            "fax_number": "216-961-5429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3569 RIDGE RD",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441025443",
            "telephone_number": "216-281-0872",
            "fax_number": "216-961-5429"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAM",
        "first_name": "MARIAN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-04-03",
        "last_updated": "2026-07-10",
        "certification_date": "2026-07-10",
        "deactivation_date": "2021-12-12",
        "reactivation_date": "2022-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A174623",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

Verify at the official NPI Registry.