Provider Demographics
NPI:1558437004
Name:MARK, DENISE ROSE (MD)
Entity type:Individual
Prefix:DR
First Name:DENISE
Middle Name:ROSE
Last Name:MARK
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Gender:F
Credentials:MD
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Mailing Address - Street 1:26335 CARMEL RANCHO BLVD
Mailing Address - Street 2:SUITE 8
Mailing Address - City:CARMEL
Mailing Address - State:CA
Mailing Address - Zip Code:93923-8876
Mailing Address - Country:US
Mailing Address - Phone:831-625-9999
Mailing Address - Fax:831-625-9903
Practice Address - Street 1:26335 CARMEL RANCHO BLVD
Practice Address - Street 2:SUITE 8
Practice Address - City:CARMEL
Practice Address - State:CA
Practice Address - Zip Code:93923-8876
Practice Address - Country:US
Practice Address - Phone:831-625-9999
Practice Address - Fax:831-625-9903
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-27
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
CAC041558207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA37630Medicare UPIN