Provider Demographics
NPI:1194913608
Name:ADRIATICO, MARK FERDINAND (MD)
Entity type:Individual
Prefix:DR
First Name:MARK
Middle Name:FERDINAND
Last Name:ADRIATICO
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:10800 PARAMOUNT BLVD
Mailing Address - Street 2:406
Mailing Address - City:DOWNEY
Mailing Address - State:CA
Mailing Address - Zip Code:90241-3331
Mailing Address - Country:US
Mailing Address - Phone:562-869-1070
Mailing Address - Fax:562-869-6317
Practice Address - Street 1:10800 PARAMOUNT BLVD
Practice Address - Street 2:406
Practice Address - City:DOWNEY
Practice Address - State:CA
Practice Address - Zip Code:90241-3331
Practice Address - Country:US
Practice Address - Phone:562-869-1070
Practice Address - Fax:562-869-6317
Is Sole Proprietor?:No
Enumeration Date:2007-10-09
Last Update Date:2009-10-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA106520207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine