# MARSHAK MEDICAL GROUP INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1770604779
- **Authorized official:** DR. HERBERT MARSHAK M.D. (M.D.)
- **Authorized official phone:** (323) 268-4436

## Contact information

- **Practice address:** 3484 E 1ST ST, LOS ANGELES, CA 90063-2946
- **Practice address phone:** (323) 268-4436
- **Practice address fax:** (323) 264-3049
- **Mailing address:** PO BOX 63194, LOS ANGELES, CA 90063-0194
- **Mailing address phone:** (323) 268-4436
- **Mailing address fax:** (323) 264-3049

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207QA0000X | Adolescent Medicine (Family Medicine) Physician | A29118 | CA | Yes |

## Other

- **Enumeration date:** 04/03/2007
- **Last updated:** 07/14/2015