MR. JACK MARK


Address: 3160 Geneva St, Los Angeles, CA 90020-1117
Phone: 2133683374

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).

Provider Overview

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

Taxonomy

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

Office Location

Street Address 3160 GENEVA ST
City LOS ANGELES
State CA
Zip Code 90020-1117

Providers in the same location

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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Providers in the same zip code

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
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Taxonomy Information

Taxonomy Code 224P00000X
Grouping Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Classification Prosthetist

Taxonomy Definition

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.

Providers in the same taxonomy and city

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

Providers in the same taxonomy and state

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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Competitor

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City LOS ANGELES
Zip Code 90020

Improve Information

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Dataset Information

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.

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