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:
Map and Directions
Authorized official contact:
Name: Leingang, Gail
Phone: (907) 561-1917

Health care specialties

SpecialtyCodeLicense #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 15 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1063694750 NPPES
Alaska MEDICAID MD1417

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