| NPI | 1073517801 |
|---|---|
| NPI Type | NPI-1 Individual |
| Status | Active |
| Enumeration Date | 2005-06-09 |
| Last Updated | 2012-08-30 |
| Mailing Address | 919 13th Ave Delano, CA 93215-2202 United States Phone: (661) 725-3795 | Fax: (661) 725-3797 📍 View Map |
| Primary Practice Address | 919 13th Ave Delano, CA 93215-2202 United States Phone: (661) 725-3795 | Fax: (661) 725-3797 📍 View Map |
| Issuer | State | Number | Other Issuer |
|---|---|---|---|
| MEDICAID | CA | SD0101520 | — |
| Primary | Taxonomy Code & Description | State | License Number |
|---|---|---|---|
| Yes | 152W00000X – Optometrist | CA | OPT10152T |
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About NPI 1073517801
Mark J Park O.D. is a healthcare provider registered in the CMS NPPES NPI Registry with NPI number 1073517801. The primary specialty listed is Optometrist. The provider is located in Delano, CA. This NPI is classified as a Type 1 (Individual) NPI and is currently active. The NPI was first enumerated (assigned) on 2005-06-09. All data is sourced directly from the official CMS NPPES public API and is updated daily.
Frequently Asked Questions
What is NPI 1073517801?
NPI 1073517801 belongs to Mark J Park O.D., a Optometrist in Delano, CA. It is a Type 1 Individual NPI registered in the CMS NPPES NPI Registry.
Is NPI 1073517801 active?
The current status of NPI 1073517801 in the NPPES registry is Active. The record was last updated on 2012-08-30.
What specialty is NPI 1073517801?
NPI 1073517801 is classified under the taxonomy Optometrist. Taxonomy codes in NPPES are maintained by the National Uniform Claim Committee (NUCC) and identify the provider's type, classification, and specialization.
How do I verify NPI 1073517801?
You can verify NPI 1073517801 at the official CMS NPPES website at npiregistry.cms.hhs.gov or using our free NPI Lookup tool above. All data shown on this page is sourced directly from the official NPPES public API and is updated daily by CMS.
What address is on file for NPI 1073517801?
The primary practice address on file for NPI 1073517801 is 919 13th Ave, Delano, CA 93215-2202. This address is registered in the NPPES system and providers are required to update it within 30 days of any change.
When was NPI 1073517801 issued?
NPI 1073517801 was first issued (enumerated) on 2005-06-09. The NPPES record was last updated on 2012-08-30.
Practice Location Map
Mark J Park is located at 919 13th Ave, Delano, CA. Use the map below to find directions or verify the practice location.
Related Healthcare Providers
The following providers share the same practice location, specialty, or state as Mark J Park. All records sourced from the CMS NPPES registry.
License Information
The following state license numbers are on file in the NPPES registry for NPI 1073517801. For license status verification, contact the relevant state licensing board directly.
| Specialty / Taxonomy | License Number | State |
|---|---|---|
| Optometrist | OPT10152T | CA |