Individual provider Active NPI

Edward Morris Marshall, M.D.

  • Internal Medicine Physician
  • Sherman Oaks, CA
National Provider Identifier
1972743904
Registry record updated Mar 4, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A20196 Issued in CA
Practice address
3763 Regal Vista Dr
Sherman Oaks, CA 91403-4802
Phone
(818) 501-0573
Fax
(818) 501-0396
NPI assigned
Mar 4, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 4, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A20196 CA Primary

Addresses

Primary practice location

3763 Regal Vista Dr
Sherman Oaks, CA 91403-4802

Mailing address

3763 Regal Vista Dr
Sherman Oaks, CA 91403-4802
Phone (818) 501-0573

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A20196CAMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1236124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1236124800000",
    "number": "1972743904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3763 REGAL VISTA DR",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914034802",
            "telephone_number": "818-501-0573",
            "fax_number": "818-501-0396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3763 REGAL VISTA DR",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914034802",
            "telephone_number": "818-501-0573",
            "fax_number": "818-501-0396"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARSHALL",
        "first_name": "EDWARD",
        "middle_name": "MORRIS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-03-04",
        "last_updated": "2009-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A20196",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sherman Oaks, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2009; 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.