Wellisch, Mark

Wellisch, Mark is an individual health care provider with primary practice located at 16311 Ventura Blvd Suite 800, Encino CA 91436-2124. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Orthopaedic Surgery, Allopathic & Osteopathic Physicians / Sports Medicine. Allopathic & Osteopathic Physicians / Orthopaedic Surgery is his primary health care specialty. Wellisch, Mark can be contacted via phone (818) 788-7343.

Contact Information

Primary practice address
16311 Ventura Blvd Suite 800 Encino CA 91436-2124
Phone: (818) 788-7343
Fax: (818) 788-9453
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X A23373 California
Allopathic & Osteopathic Physicians / Sports Medicine 207XX0005X A23373 California
Allopathic & Osteopathic Physicians / Sports Medicine 2080S0010X A23373 California

Profile Details

NPI number 1982685996
LBN Legal business name Wellisch, Mark
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 7th, 2005
Last updated Jul 8th, 2007 - about 19 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 1982685996 NPPES
California MEDICAID 00A233730

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