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LARRY MARIANELLA MD A PROFESSIONAL CORP. NPI 1104128941


NPI Information

NPI: 1104128941
Provider Name: LARRY MARIANELLA, MD A PROFESSIONAL CORP.
Classification: Internal Medicine - 207R00000X
Entity Type: Organization
Address:
1515 MONTGOMERY DR
SANTA ROSA, CA
ZIP 95405
Phone: (707) 526-4865
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LARRY MARIANELLA, MD A PROFESSIONAL CORP. is an internal medicine in Santa Rosa, CA. The provider is a physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. LARRY MARIANELLA, MD A PROFESSIONAL CORP. NPI is 1104128941. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1515 MONTGOMERY DR
SANTA ROSA, CA
ZIP 95405-500
Phone: (707) 526-4865
Fax: (707) 526-5375

The provider's authorized official is Larry Marianella .
The authorized official title is President and has the following contact phone number (707) 526-4865.

The enumeration date for this NPI number is 11/30/2010 and was last updated on 11/30/2010.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207R00000XInternal MedicineG38835CALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
100G388351MEDICAIDCALIFORNIA
200G388350MEDICARE PINCALIFORNIA
3A47615MEDICARE UPINCALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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