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Organization
LARRY MARIANELLA, MD A PROFESSIONAL CORP.
Active
Organization
LARRY MARIANELLA, MD A PROFESSIONAL CORP.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LARRY MARIANELLA M.D. (PRESIDENT)
(707) 526-4865
Entity
Organization
Contact information
Practice address
1515 MONTGOMERY DR, SANTA ROSA, CA 95405-4500
(707) 526-4865
(707) 526-5375
Mailing address
1515 MONTGOMERY DR, SANTA ROSA, CA 95405-4500
(707) 526-4865
(707) 526-5375
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
G38835
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G388351
—
CA
Enumeration date
11/30/2010
Last updated
11/30/2010
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