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ODYSSEY MEDICAL GROUP NPI 1932320256


NPI Information

NPI: 1932320256
Provider Name: ODYSSEY MEDICAL GROUP
Classification: Specialist - 174400000X
Entity Type: Organization
Address:
4832 LINCOLN BLVD
MARINA DEL REY, CA
ZIP 90292
Phone: (310) 821-7658
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ODYSSEY MEDICAL GROUP is a specialist in Marina Del Rey, CA. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. ODYSSEY MEDICAL GROUP NPI is 1932320256. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

4832 LINCOLN BLVD
MARINA DEL REY, CA
ZIP 90292-917
Phone: (310) 821-7658
Fax: (310) 821-1708

The provider's authorized official is Marica Glenn .
The authorized official title is Owner and has the following contact phone number (310) 821-7658.

The enumeration date for this NPI number is 5/2/2007 and was last updated on 8/22/2020.


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
1174400000XSpecialistE4238CALIFORNIANo
2174400000XSpecialistC35069CALIFORNIANo
3174400000XSpecialistA96388CALIFORNIANo
4174400000XSpecialistG79180CALIFORNIAYes

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: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.