MR. JACK MARK (NPI# 1699228619) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1699228619 |
Entity Type | Individual |
Full Name | MR. JACK MARK |
Credential | CPO |
Practice Address |
3160 Geneva St Los Angeles CA 90020-1117 |
Practice Telephone | 2133683374 |
Mailing Telephone | 2133683374 |
Enumeration Date | 2016-07-26 |
Last Update Date | 2016-07-26 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 222Z00000X | Orthotist | CPO01066 | DE | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Y | 224P00000X | Prosthetist | CPO01066 | DE | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Street Address |
3160 GENEVA ST |
City | LOS ANGELES |
State | CA |
Zip Code | 90020-1117 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1790758969 | Colin Frederick Moseley | Orthopaedic Surgery | 3160 Geneva St, Los Angeles, CA 90020-1117 | 2006-02-08 |
1841744034 | David Craft | Prosthetist | 3160 Geneva St, Los Angeles, CA 90020-1117 | 2016-08-05 |
1396119400 | Nancy Carney | Occupational Therapist | 3160 Geneva St, Los Angeles, CA 90020-1117 | 2015-12-01 |
1861879215 | Olga Coto | Registered Nurse | 3160 Geneva St, Los Angeles, CA 90020-1117 | 2015-05-05 |
1619364445 | Alexsandra Youkhanneh-morales | Registered Nurse | 3160 Geneva St, Los Angeles, CA 90020-1117 | 2015-04-20 |
1679902746 | Graham Fedorak | Orthopaedic Surgery | 3160 Geneva St, Los Angeles, CA 90020-1117 | 2013-11-08 |
1215379102 | Shriners Hospitals for Children | Orthopaedic Surgery | 3160 Geneva St, Los Angeles, CA 90020-1117 | 2013-07-22 |
1003152331 | Alma Luna Wells | Anesthesiology | 3160 Geneva St, Los Angeles, CA 90020-1117 | 2012-12-13 |
1255640868 | Arash Ari Arshi | Pharmacist | 3160 Geneva St, Pharmacy Department, Los Angeles, CA 90020-1117 | 2010-09-30 |
1043524051 | Hugh Watts | Orthopaedic Surgery | 3160 Geneva St, Los Angeles, CA 90020-1117 | 2010-08-02 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1164948048 | Edwina Antoinette Hunter | Community Health Worker | 550 S. Vermont Ave, 6th Floor, Los Angeles, CA 90020 | 2017-08-22 |
1639520661 | Jacqueline Carrasco | Counselor | 550 South Vermont Ave, 10th Floor, Los Angeles, CA 90020 | 2016-06-30 |
1649630914 | Hee Seung Lee | Marriage & Family Therapist | 3727 W. 6th Street, Suite 507, Los Angeles, CA 90020 | 2016-03-01 |
1134596273 | Jocelyn Marie Lee | Optometrist | 3750 W 6th St Ste 113, Los Angeles, CA 90020 | 2015-08-24 |
1316327075 | Lourdes Encarnacion Araujo | Social Worker | 550 S Vermont Ave 3rd Floor, Los Angeles, CA 90020 | 2015-06-08 |
1477933463 | Department of Mental Health | Clinic/Center | 550 South Vermont, Los Angeles, CA 90020 | 2015-06-04 |
1538566047 | Calvin A. Kim | Internal Medicine | 4220 W 3rd St Ste 201, Los Angeles, CA 90020 | 2014-11-26 |
1093115792 | John Abaya | Counselor | 550 S Vermont Ave 10th Floor, Los Angeles, CA 90020 | 2014-08-29 |
1528494481 | Sung Eun Lee | Acupuncturist | 340 S New Hampshire Ave #211, Los Angeles, CA 90020 | 2013-09-23 |
1861836587 | Robert Lee Smalls Jr. | Marriage & Family Therapist | 550 South Vermont Avenue, Juvenile Justice Transition Aftercare Services Division, Los Angeles, CA 90020 | 2013-04-24 |
Find all providers in zip 90020 |
Taxonomy Code | 224P00000X |
Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Classification | Prosthetist |
A health care professional who is specifically educated and trained to manage comprehensive prosthetic patient care for individuals who have sustained complete or partial limb loss or absence. Prosthetists assess specific patient needs, formulate an appropriate treatment plan, implement the treatment plan and provide follow-up care. |
Notes: Source: American Board for Certification in Orthotics, Prosthetics, and Pedorthics, Inc. [7/1/2010: modified, 7/1/2013: modified] Additional Resources: American Board for Certification in Orthotics, Prosthetics and Pedorthics, Inc., www.abcop.org and Board of Certification/Accreditation, International, www.bocusa.org. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1831733948 | Shayla R Williams | Prosthetist | 11050 Strathmore Dr Apt 422, Los Angeles, CA 90024-2319 | 2019-10-31 |
1255815155 | Mary Alice Swiney | Prosthetist | 3437 Stocker St Apt 4, Los Angeles, CA 90008-3730 | 2018-09-18 |
1114013158 | Los Angeles Institute for Prosthetics and Orthotics Inc | Prosthetist | 443 1/2 So Atlantic Blvd, Los Angeles, CA 90022-2617 | 2006-10-05 |
1033736848 | Sue Sean | Prosthetist | 1830 W Olympic Blvd Ste 123, Los Angeles, CA 90006-3734 | 2020-06-26 |
1770082570 | Matthew Mills | Prosthetist | 6300 Wilshire Blvd, Los Angeles, CA 90048-5204 | 2018-02-07 |
1841744034 | David Craft | Prosthetist | 3160 Geneva St, Los Angeles, CA 90020-1117 | 2016-08-05 |
1497911572 | Shane Richard Wurdeman | Prosthetist | 11301 Wilshire Blvd, Bldg 304, Los Angeles, CA 90073-1003 | 2008-07-29 |
1316134802 | Suzanne Mary Eckhardt | Prosthetist | 637 Lucas Ave, Los Angeles, CA 90017-1912 | 2007-09-27 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1134752942 | Elizabeth Olajide | Prosthetist | 43536 Gadsden Ave Apt 324, Lancaster, CA 93534-6036 | 2020-02-20 |
1578111290 | Charmie Johnson | Prosthetist | 7309 University Ave Ste B, La Mesa, CA 91942-0525 | 2019-08-27 |
1790341915 | Gloria Tatiana Dixon | Prosthetist | 32366 Evening Primrose Trl, Campo, CA 91906-3162 | 2019-05-13 |
1629633219 | Duana Robinson | Prosthetist | 1430 Brandon Dewey Ln, Tracy, CA 95304-5981 | 2019-05-08 |
1366908741 | Alicia Lander | Prosthetist | 5252 Foothill Blvd, Oakland, CA 94601-5438 | 2019-02-11 |
1154895944 | Keyonia K Paramore | Prosthetist | 735 W Pacific Coast Hwy, Long Beach, CA 90806-5240 | 2019-01-15 |
1629544499 | Alexander Hetherington | Prosthetist | 1500 Owens St Ste 115, San Francisco, CA 94158-2338 | 2018-10-19 |
1285113951 | Janet Miller | Prosthetist | 6662 Charlene Ave, San Diego, CA 92114 | 2018-08-13 |
1710482807 | John Vetter | Prosthetist | 5110 Whitsett Ave, Valley Village, CA 91607-3016 | 2018-03-29 |
1144728569 | Shiaw Wen Wu | Prosthetist | 1009 N Orange Ave, Azusa, CA 91702-1920 | 2018-01-31 |
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City | LOS ANGELES |
Zip Code | 90020 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.