Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | G60287 | CA |
NPI | 1093710345 |
---|---|
Provider Name | Dr. Mark L Geller |
First Address | Mission Hills, CA 91346-9602 |
Second Address | Tarzana, CA 91356-3641 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/06/2005 |
Last Update Date | 23/10/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
110061982 | RAILROAD RENDERING NUMBER (01) | CA |
95-3132732 | BLUE CROSS OF CALIFORNIA (01) | CA |
F38967 | (02) | CA |
T0796 | RAILROAD GROUP NUMBER (01) | CA |
WG60287A | MEDICARE RENDERING NUMBER (01) | CA |
YYY40048Y | (05) | CA |
YYY40048Y | BLUE SHIELD OF CALIFORNIA (01) | CA |