Provider Demographics
NPI:1477510758
Name:MARANGI, KENT S (MD)
Entity Type:Individual
Prefix:
First Name:KENT
Middle Name:S
Last Name:MARANGI
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:26401 CROWN VALLEY PKWY
Mailing Address - Street 2:STE 101
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92691-6302
Mailing Address - Country:US
Mailing Address - Phone:949-348-4000
Mailing Address - Fax:949-348-1435
Practice Address - Street 1:21213B HAWTHORNE BLVD #5603
Practice Address - Street 2:C/O M. MAGALLON
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90503
Practice Address - Country:US
Practice Address - Phone:951-292-0269
Practice Address - Fax:951-292-0269
Is Sole Proprietor?:No
Enumeration Date:2006-04-28
Last Update Date:2023-03-07
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Provider Licenses
StateLicense IDTaxonomies
CAG69562207XX0005X, 207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CABM2563523OtherDEA
CAWG69562AMedicare PIN
CAG12978Medicare UPIN