Condell, Mark Guy

Condell, Mark Guy is an sole proprietor health care provider with primary practice located at 27201 Regio , Mission Viejo CA 92692-3206. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Condell, Mark Guy can be contacted via phone (949) 701-2576.

Contact Information

Primary practice address
27201 Regio Mission Viejo CA 92692-3206
Phone: (949) 701-2576
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X OPT7778T California

Profile Details

NPI number 1619959079
LBN Legal business name Condell, Mark Guy
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 18th, 2005
Last updated Apr 3rd, 2019 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1619959079 NPPES
California MEDICAID SD007778

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