Organization
MARINELLI & FELDMAN MDS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANGELICA MARIA REYES (OFFICE MANAGER)
(714) 879-2410
Entity
Organization
Contact information
Practice address
1915 SUNNY CREST DR, FULLERTON, CA 92835-3626
(714) 879-2410
(714) 879-5340
Mailing address
1915 SUNNY CREST DR, FULLERTON, CA 92835-3626
(714) 879-2410
(714) 879-5340
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
A79874
CA
208800000X
Urology Physician
Primary
G59971
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05D0684380
CLIA
CA
01
—
G41816
MEDI CAL RENDERING
CA
01
—
G59971
MEDI-CAL RENDERING
CA
05
—
GR0011581
—
CA
Enumeration date
09/20/2006
Last updated
09/15/2020
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