Logan, Mark

Logan, Mark is an individual health care provider with primary practice located at 215 Pesetas Ln , Santa Barbara CA 93110-1416. He recently has only one registered license in Allopathic & Osteopathic Physicians / Procedural Dermatology, which is considered as his primary health care specialty. Logan, Mark can be contacted via phone (805) 681-1761.

Contact Information

Primary practice address
215 Pesetas Ln Santa Barbara CA 93110-1416
Phone: (805) 681-1761
Fax: (805) 681-1768
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Procedural Dermatology 207NS0135X G59298 California

Profile Details

NPI number 1902819964
LBN Legal business name Logan, Mark
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 14th, 2006
Last updated May 23rd, 2011 - about 15 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 1902819964 NPPES
California MEDICAID 00G592980

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