Marvin John Grendahl Md A Professional Corp.
LBN: Marvin John Grendahl Md A Professional Corp.
Marvin John Grendahl Md A Professional Corp. is an health care organization with primary practice located at 3500 Latouche St Ste 280 , Anchorage AK 99508-4261. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as the primary health care specialty.
Marvin John Grendahl Md A Professional Corp. can be contacted via phone (907) 561-1917, or through Leingang, Gail via phone (907) 561-1917.
Contact Information
Primary practice address
3500 Latouche St Ste 280
Anchorage AK 99508-4261
Phone: (907) 561-1917
Fax: (907) 563-5373
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Ophthalmology | 207W00000X | MD1417 | Alaska |
| Allopathic & Osteopathic Physicians / Ophthalmology | 207W00000X | MD3686 | Alaska |
Profile Details
| NPI number | 1063694750 |
|---|---|
| LBN Legal business name | Marvin John Grendahl Md A Professional Corp. |
| DBA Doing business as | |
| Authorized official | Leingang, Gail |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Dec 4th, 2007 |
| Last updated | Nov 22nd, 2011 - about 14 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1063694750 | NPPES |
| Alaska | MEDICAID | MD1417 |
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