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:
Health care specialties
| Specialty | Code | License # | 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 7 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1619959079 | NPPES |
| California | MEDICAID | SD007778 |
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