Provider Demographics
NPI:1851587885
Name:MARINELLI & FELDMAN, M.D.'S
Entity Type:Organization
Organization Name:MARINELLI & FELDMAN, M.D.'S
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:ILENE
Authorized Official - Middle Name:
Authorized Official - Last Name:MEYER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-879-2410
Mailing Address - Street 1:400 W CENTRAL AVE
Mailing Address - Street 2:#207
Mailing Address - City:BREA
Mailing Address - State:CA
Mailing Address - Zip Code:92821-3013
Mailing Address - Country:US
Mailing Address - Phone:714-879-2410
Mailing Address - Fax:714-879-5340
Practice Address - Street 1:400 W CENTRAL AVE
Practice Address - Street 2:#207
Practice Address - City:BREA
Practice Address - State:CA
Practice Address - Zip Code:92821-3013
Practice Address - Country:US
Practice Address - Phone:714-879-2410
Practice Address - Fax:714-879-5340
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-24
Last Update Date:2007-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE91849208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGR0011581OtherMEDI CAL
CAW450BOtherMEDICARE GROUP
CAYYY49655YOtherBLUE SHIELD GROUP
CAW450OtherMEDICARE GROUP
CAW450AOtherMEDICARE GROUP
CAWA79874BMedicare PIN
CAW450OtherMEDICARE GROUP
CAWG59971BMedicare PIN
CAW450BOtherMEDICARE GROUP
CAYYY49655YOtherBLUE SHIELD GROUP
CAA48702Medicare UPIN
CAWG59971CMedicare PIN
CAWG41816BMedicare PIN
CAE91849Medicare UPIN
CAWG59971AMedicare PIN
CAWG41816CMedicare PIN
CAWG41816AMedicare PIN