MR. MARCUS A NESBETH (NPI# 1548396310) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548396310 |
| Entity Type | Individual |
| Full Name | MR. MARCUS A NESBETH |
| Credential | PA-C |
| Practice Address |
12021 Wilmington Ave Los Angeles CA 90059-3019 |
| Mailing Address |
6330 Rugby Ave Apt 424 Huntington Park CA 90255-4066 |
| Practice Telephone | 3106684515 |
| Practice Fax Number | 3107638909 |
| Enumeration Date | 2007-02-26 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PA18244 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
12021 WILMINGTON AVE |
| City | LOS ANGELES |
| State | CA |
| Zip Code | 90059-3019 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750351300 | Gangadarshni Chandramohan | Pediatrics | 12021 Wilmington Ave, Los Angeles, CA 90059-3019 | 2006-01-25 |
| 1639704323 | Martin Luther King Jr Community Medical Group-wilmington Ave | Case Manager/Care Coordinator | 12021 Wilmington Ave, Building 11, Suite 1000, Los Angeles, CA 90059 | 2020-03-03 |
| 1114418928 | Exodus Recovery, Inc. | Community/Behavioral Health | 12021 Wilmington Ave, Los Angeles, CA 90059-3019 | 2018-05-29 |
| 1043759855 | Los Angeles County Department of Mental Health | Clinic/Center | 12021 Wilmington Ave, Los Angeles, CA 90059 | 2017-02-14 |
| 1053855064 | Maria Casarez-romero | Rehabilitation Practitioner | 12021 Wilmington Ave, Los Angeles, CA 90059-3019 | 2016-12-09 |
| 1295279453 | Kelsey Collins | Marriage & Family Therapist | 12021 Wilmington Ave, Los Angeles, CA 90059-3019 | 2016-12-07 |
| 1639628035 | Stella Cuomo | Student in an Organized Health Care Education/Training Program | 12021 Wilmington Ave, Los Angeles, CA 90059-3019 | 2016-09-26 |
| 1821443995 | Patanya Matthews | Counselor | 12021 Wilmington Ave, Los Angeles, CA 90059-3019 | 2016-04-26 |
| 1043677289 | Kita Stovall | Nurse Practitioner | 12021 Wilmington Ave, Los Angeles, CA 90059 | 2016-01-19 |
| 1417314741 | Noele Le Flore | Nurse Practitioner | 12021 Wilmington Ave, Los Angeles, CA 90059-3019 | 2016-01-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235759788 | Juan Jimenez Jr. | Technician, Pathology | 1860 E 120th St, Los Angeles, CA 90059 | 2020-04-24 |
| 1538717780 | Donald O Nwanze | Pharmacist | Mlk Outpatient Center (pharmacy), 1670 East 120th Street, Los Angeles, CA 90059 | 2019-08-30 |
| 1295391050 | Sheela Hoyle | Counselor | 836 East Saucer Lane, Los Angeles, CA 90059 | 2019-05-16 |
| 1750852471 | Carlos Tovar Sr. | Community Health Worker | 1720 E 120st, Los Angeles, CA 90059 | 2018-12-06 |
| 1699293910 | Amy Caryn Bolenbaugh | Recreation Therapist | 1720 E 120th Street, Los Angeles, CA 90059 | 2017-09-07 |
| 1417475757 | Scott Lee Jones | Recreation Therapist | Augustus F. Hawkins, 1720 E. 120th Street, Rm. 2196, Los Angeles, CA 90059 | 2017-09-07 |
| 1881118859 | Darlene Renee Tillman | Speech-Language Pathologist | 1670 E 120th Strret, Los Angeles, CA 90059 | 2017-08-01 |
| 1609306430 | Valda Therese Flores | Registered Nurse | 1670 E. 120th Street, Los Angeles, CA 90059 | 2017-06-14 |
| 1093244006 | Bongsill Chung | Registered Nurse | 1670 East 120th St, Los Angeles, CA 90059 | 2017-06-05 |
| 1730573395 | Apollonia Godoy | Registered Nurse | 1670 E. 120th St, 4th Floor, Module A, Los Angeles, CA 90059 | 2015-03-22 |
| Find all providers in zip 90059 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154929644 | Tatum Little | Physician Assistant | 3307 W 79th St, Los Angeles, CA 90043-5249 | 2020-10-15 |
| 1144828963 | Chan Ho Park | Physician Assistant | 4721 Oakwood Ave, Los Angeles, CA 90004-3112 | 2020-10-14 |
| 1235737172 | Jennifer Rae Levitt Physician Assistant, Inc | Physician Assistant | 1439 N Highland Ave Ste 1059, Los Angeles, CA 90028-7622 | 2020-10-13 |
| 1174120943 | Melody Fatehi | Physician Assistant | 6228 Orange St Apt 9, Los Angeles, CA 90048-4836 | 2020-10-05 |
| 1467063826 | Hannah Shannon Rihani | Physician Assistant | 1737 Midvale Ave, Los Angeles, CA 90024-5512 | 2020-08-11 |
| 1356969901 | Emily Rachel Lavi | Physician Assistant | 1132 S Holt Ave Apt 7, Los Angeles, CA 90035-2424 | 2020-07-09 |
| 1083242952 | Julia Andrea Hurtado | Physician Assistant | 3783 Cimarron St, Los Angeles, CA 90018-4463 | 2020-03-27 |
| 1174150130 | Susan C. Williams | Physician Assistant | 2215 Alcazar St, Los Angeles, CA 90033-1003 | 2020-03-26 |
| 1720615776 | Shannon Hakakeyan | Physician Assistant | 1580 Manning Ave Apt 303, Los Angeles, CA 90024-6086 | 2020-03-26 |
| 1952938243 | Jayanti Sharma | Physician Assistant | 1515 Amherst Ave Apt 303, Los Angeles, CA 90025-3677 | 2020-03-25 |
| Find all providers in LOS ANGELES | ||||
| City | LOS ANGELES |
| Zip Code | 90059 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.