Provider Demographics
NPI:1487735288
Name:STOKES, MARK R (DC)
Entity type:Individual
Prefix:
First Name:MARK
Middle Name:R
Last Name:STOKES
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
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Mailing Address - Street 1:15520 ROCKFIELD BLVD A200
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-6705
Mailing Address - Country:US
Mailing Address - Phone:949-598-9999
Mailing Address - Fax:949-598-9990
Practice Address - Street 1:3325 PALO VERDE AVE
Practice Address - Street 2:204
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90808-4132
Practice Address - Country:US
Practice Address - Phone:562-497-8787
Practice Address - Fax:562-497-8790
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2015-10-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CADC10691111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC0106910OtherBLUE SHIELD
CADC10691Medicare ID - Type Unspecified
CAT16955Medicare UPIN