Provider Demographics
NPI:1982775987
Name:STRASSBERG, MARK HOWARD (MD)
Entity type:Individual
Prefix:DR
First Name:MARK
Middle Name:HOWARD
Last Name:STRASSBERG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 VAN NESS AVE
Mailing Address - Street 2:STE 610
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94109-3016
Mailing Address - Country:US
Mailing Address - Phone:415-749-6820
Mailing Address - Fax:415-673-4829
Practice Address - Street 1:2000 VAN NESS AVE
Practice Address - Street 2:STE 610
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94109-3016
Practice Address - Country:US
Practice Address - Phone:415-749-6820
Practice Address - Fax:415-673-4829
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-13
Last Update Date:2019-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG0382842084N0400X, 2084P0800X
CAGO382842084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA47426Medicare UPIN
CA00G382840Medicare ID - Type UnspecifiedMEDICARE NUMBER