| Larry Marianella, Md A Professional Corp. | |
|
1515 Montgomery Dr Santa Rosa CA 95405-4500 | |
| (707) 526-4865 | |
| (707) 526-5375 |
| Full Name | Larry Marianella, Md A Professional Corp. |
|---|---|
| Speciality | Internal Medicine |
| Location | 1515 Montgomery Dr, Santa Rosa, California |
| Authorized Official Name and Position | Larry Marianella (PRESIDENT) |
| Authorized Official Contact | 7075264865 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Larry Marianella, Md A Professional Corp. 1515 Montgomery Dr Santa Rosa CA 95405-4500 Ph: (707) 526-4865 | Larry Marianella, Md A Professional Corp. 1515 Montgomery Dr Santa Rosa CA 95405-4500 Ph: (707) 526-4865 |
| NPI Number | 1104128941 |
|---|---|
| Provider Enumeration Date | 11/30/2010 |
| Last Update Date | 11/30/2010 |
| Medicare PECOS PAC ID | 8224224274 |
|---|---|
| Medicare Enrollment ID | O20101202000339 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104128941 | NPI | - | NPPES |
| 00G388351 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | G38835 (California) | Primary |
| Provider Name | Larry Marianella |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1144257486 PECOS PAC ID: 7012103070 Enrollment ID: I20101202000395 |
Sutter Medical Group Of The Redwoods Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4725a Hoen Ave, Santa Rosa, CA 95405 Phone: 707-576-3322 | |
Elyse R. Eisenberg, Md, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 725 Farmers Ln, Ste 10, Santa Rosa, CA 95405 Phone: 707-523-3375 Fax: 866-870-0815 | |
Sutter Medical Group Of The Redwoods Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4750 Hoen Ave, Santa Rosa, CA 95405 Phone: 707-523-2666 Fax: 707-523-3399 | |
St Joseph Heritage Healthcare Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4750 Hoen Ave, Santa Rosa, CA 95405 Phone: 707-542-1611 Fax: 707-542-9958 | |
Thomas M. Collins Chiropractic, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1212 Farmers Ln, Suite 2, Santa Rosa, CA 95405 Phone: 707-566-7396 Fax: 707-566-7398 | |
Vanguard Performance Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2901 Cleveland Ave Ste 202, Santa Rosa, CA 95403 Phone: 707-968-1555 Fax: 844-426-0134 | |
Sonoma County Junior College District Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1501 Mendocino Ave, Santa Rosa, CA 95401 Phone: 707-527-4445 Fax: 707-524-1858 |