Mark, Jack

Mark, Jack is an individual health care provider with primary practice located at 3160 Geneva St , Los Angeles CA 90020-1117. He recently has 2 registered licenses in different health care specialties including Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Orthotist, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Prosthetist. Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Prosthetist is his primary health care specialty. Mark, Jack can be contacted via phone (213) 368-3374.

Contact Information

Primary practice address
3160 Geneva St Los Angeles CA 90020-1117
Phone: (213) 368-3374
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Orthotist 222Z00000X CPO01066 Delaware
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Prosthetist 224P00000X CPO01066 Delaware

Profile Details

NPI number 1699228619
LBN Legal business name Mark, Jack
Credentials CPO
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 26th, 2016
Last updated Jul 26th, 2016 - about 10 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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