Provider Demographics
NPI:1154469898
Name:LOUIS E. MARCHIOLI, M.D., INC
Entity Type:Organization
Organization Name:LOUIS E. MARCHIOLI, M.D., INC
Other - Org Name:ALLERGY MEDICAL GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:LOUIS
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:MARCHIOLI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:562-902-1014
Mailing Address - Street 1:15040 IMPERIAL HWY
Mailing Address - Street 2:
Mailing Address - City:LA MIRADA
Mailing Address - State:CA
Mailing Address - Zip Code:90638-1301
Mailing Address - Country:US
Mailing Address - Phone:562-902-1014
Mailing Address - Fax:562-902-1015
Practice Address - Street 1:15040 IMPERIAL HWY
Practice Address - Street 2:
Practice Address - City:LA MIRADA
Practice Address - State:CA
Practice Address - Zip Code:90638-1301
Practice Address - Country:US
Practice Address - Phone:562-902-1014
Practice Address - Fax:562-902-1015
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC35395174400000X
CAA046017174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1164414603OtherLOUIS E. MARCHIOLI
CA1669465225OtherJUNGMEE KIM, M.D.
CAWA046017AMedicare ID - Type UnspecifiedJUNGMEE KIM, M.D.
CAA87796Medicare UPIN
CAG18368Medicare UPIN
CAWC35395AMedicare ID - Type UnspecifiedLOUIS E. MARCHIOLI, M.D.
CA1164414603OtherLOUIS E. MARCHIOLI