Active NPI
Stephen S Marmer, M.D.
- Psychiatry Physician
- Los Angeles, CA
National Provider Identifier
1891993309
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- G18313
- Practice address
- 11611 San Vicente Blvd
Suite 510
Los Angeles, CA 90049-5106 - Phone
- (310) 820-4990
- Fax
- (310) 207-7103
- NPI assigned
- Jul 5, 2007
- Last updated
- Jul 8, 2007
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | G18313 | CA | Primary |
Addresses
Primary practice location
11611 San Vicente Blvd
Suite 510
Los Angeles, CA 90049-5106
Mailing address
11611 San Vicente Blvd
Suite 510
Los Angeles, CA 90049-5106
Phone (310) 820-4990
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| G18313 | Other | CA | STATE LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Dec 3, 2018 through Dec 3, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G18313 | CA | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1183593600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1891993309",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11611 SAN VICENTE BLVD",
"address_2": "SUITE 510",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900495106",
"telephone_number": "310-820-4990",
"fax_number": "310-207-7103"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11611 SAN VICENTE BLVD",
"address_2": "SUITE 510",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900495106",
"telephone_number": "310-820-4990",
"fax_number": "310-207-7103"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARMER",
"first_name": "STEPHEN",
"middle_name": "S",
"name_prefix": "Mr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-07-05",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "CA",
"license": "G18313",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE",
"identifier": "G18313",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.