# INNOVATIVE MEDICAL SOLUTIONS INC A MEDICAL GROUP

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

## Provider details

- **NPI number:** 1972624955
- **Authorized official:** DR. GLENN A MARSHAK M.D. (OWNER)
- **Authorized official phone:** (310) 553-5203

## Contact information

- **Practice address:** 14860 ROSCOE BLVD STE 200, PANORAMA CITY, CA 91402-4683
- **Practice address phone:** (310) 553-5203
- **Mailing address:** PO BOX 15655, BEVERLY HILLS, CA 90209-1655
- **Mailing address phone:** (310) 553-5203
- **Mailing address fax:** (310) 659-0933

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RA0000X | Adolescent Medicine (Internal Medicine) Physician | G78454 | CA | Yes |

## Other

- **Enumeration date:** 04/03/2007
- **Last updated:** 09/18/2024