Provider Demographics
NPI:1578639001
Name:M S CHERKAS MD MED CORP
Entity Type:Organization
Organization Name:M S CHERKAS MD MED CORP
Other - Org Name:MARSHALL S CHERKAS MD
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARSHALL
Authorized Official - Middle Name:S
Authorized Official - Last Name:CHERKAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-826-5622
Mailing Address - Street 1:12304 SANTA MONICA BLVD
Mailing Address - Street 2:S 300
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90025
Mailing Address - Country:US
Mailing Address - Phone:310-826-5622
Mailing Address - Fax:310-207-0093
Practice Address - Street 1:12304 SANTA MONICA BLVD
Practice Address - Street 2:S 300
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90025
Practice Address - Country:US
Practice Address - Phone:310-826-5622
Practice Address - Fax:310-207-0093
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-27
Last Update Date:2008-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG62062084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG6206Medicare ID - Type Unspecified