Provider Demographics
NPI:1265614341
Name:HARDART, MARCELLA B (MD)
Entity type:Individual
Prefix:DR
First Name:MARCELLA
Middle Name:B
Last Name:HARDART
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:910 VIA DE LA PAZ
Mailing Address - Street 2:STE 207
Mailing Address - City:PACIFIC PALISADES
Mailing Address - State:CA
Mailing Address - Zip Code:90272-3515
Mailing Address - Country:US
Mailing Address - Phone:310-454-4466
Mailing Address - Fax:310-454-0916
Practice Address - Street 1:910 VIA DE LA PAZ
Practice Address - Street 2:STE 207
Practice Address - City:PACIFIC PALISADES
Practice Address - State:CA
Practice Address - Zip Code:90272-3515
Practice Address - Country:US
Practice Address - Phone:310-454-4466
Practice Address - Fax:310-454-0916
Is Sole Proprietor?:No
Enumeration Date:2007-11-30
Last Update Date:2007-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA93391208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics