Provider Demographics
NPI:1194737619
Name:NEIMARK, NEIL F (MD)
Entity type:Individual
Prefix:
First Name:NEIL
Middle Name:F
Last Name:NEIMARK
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:4980 BARRANCA PKWY
Mailing Address - Street 2:SUITE 207
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92604-8645
Mailing Address - Country:US
Mailing Address - Phone:949-502-5656
Mailing Address - Fax:949-502-5647
Practice Address - Street 1:4980 BARRANCA PKWY
Practice Address - Street 2:SUITE 207
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92604-8645
Practice Address - Country:US
Practice Address - Phone:949-502-5656
Practice Address - Fax:949-502-5647
Is Sole Proprietor?:No
Enumeration Date:2006-08-13
Last Update Date:2007-07-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAG061767207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG061767OtherSTATE LICENSE
CAWG61767DMedicare PIN
CAG061767OtherSTATE LICENSE
CAA17097Medicare UPIN