Individual
DR. MARK L GELLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
18133 VENTURA BLVD, SUITE 204, TARZANA, CA 91356-3641
(818) 466-7700
(818) 996-1649
Mailing address
PO BOX 9602, MISSION HILLS, CA 91346-9602
(818) 837-5559
(818) 792-4793
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
G60287
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110061982
RAILROAD RENDERING NUMBER
CA
01
—
95-3132732
BLUE CROSS OF CALIFORNIA
CA
01
—
T0796
RAILROAD GROUP NUMBER
CA
01
—
WG60287A
MEDICARE RENDERING NUMBER
CA
01
—
YYY40048Y
BLUE SHIELD OF CALIFORNIA
CA
05
—
YYY40048Y
—
CA
Enumeration date
06/14/2005
Last updated
10/23/2018
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