MR. MARK ALAN LOGAN (NPI# 1780107433) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780107433 |
| Entity Type | Individual |
| Full Name | MR. MARK ALAN LOGAN |
| Credential | PMHNP-BC |
| Practice Address |
107 1/2 N Columbus Ave Glendale CA 91203-2504 |
| Mailing Address |
107 1/2 N Columbus Ave Glendale CA 91203-2511 |
| Practice Telephone | 9136341341 |
| Practice Fax Number | 8449411989 |
| Mailing Telephone | 9136341341 |
| Enumeration Date | 2017-07-24 |
| Last Update Date | 2020-05-07 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
NP95013193 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2750 E Washington Blvd Ste 230, Pasadena, CA 911071449 | 6262968900 | |
| 3133 N Millbrook Ave, Fresno, CA 937031425 | 5596008918 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184679227 | Mark Edward Logan | Internal Medicine | 199 Stratton Rd, Rutland, VT 05701-4621 | 2006-05-24 |
| 1346800612 | Mark Logan | Case Manager/Care Coordinator | 6666 Green Valley Cir, Culver City, CA 90230-7068 | 2019-06-18 |
| 1851413603 | Mark Alan Logan | Pharmacist | 12028 Majestic Blvd, Hudson, FL 34667-2418 | 2007-04-04 |
| 1508994104 | Mark J Logan | Physician Assistant | 3841 Piper St, Suite T300, Anchorage, AK 99508-4624 | 2007-03-02 |
| 1548323140 | Mark Logan | Chiropractor | 340 Wood Rd, Ste 303, Braintree, MA 02184-2404 | 2006-12-18 |
| 1902819964 | Mark Logan | Dermatology | 215 Pesetas Ln, Santa Barbara, CA 93110-1416 | 2006-08-14 |
| 1760426803 | Mark P Logan | Dentist | 123 Dwight Rd, Longmeadow, MA 01106-1748 | 2006-06-16 |
| 1720077407 | Mark Logan | Otolaryngology | 1020 Professional Blvd, Evansville, IN 47714-8009 | 2005-10-17 |
| Street Address |
107 1/2 N COLUMBUS AVE |
| City | GLENDALE |
| State | CA |
| Zip Code | 91203-2504 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487115044 | Family & Friends Home Health Care Inc | Home Health | 417 W Arden St Suite 106a, Glendale, CA 91203 | 2019-03-27 |
| 1801354758 | Remedy Medical of California PC | Emergency Medicine | 138 N. Brand Blvd., Ste. 200, Unit 163, Glendale, CA 91203 | 2019-03-11 |
| 1609381730 | Envoy Hospice Care Inc | Hospice Care, Community Based | 5002 N Central Ave Ste 510, Glendale, CA 91203 | 2017-12-12 |
| 1093227712 | Goarik Susan Akopyan | Case Manager/Care Coordinator | 237 N Central Ave, Glendale, Ca 91203, Glendale, CA 91203 | 2017-11-03 |
| 1588190664 | Vanessa Guzman | Physician Assistant | 600 N. Central Ave, 322, Glendale, CA 91203 | 2017-05-10 |
| 1114465796 | Elizabeth Pedroza Estrada | Case Manager/Care Coordinator | 237 North Glendale, Glendale, CA 91203 | 2017-02-03 |
| 1477090934 | Blue Med-ride Medical Transportation | Non-emergency Medical Transport (VAN) | 121 W Lexington Dr # L200, Glendale, CA 91203 | 2017-01-23 |
| 1427593557 | Ofelia Oundjian | Counselor | 237 N Central Ave., Glendale, CA 91203 | 2016-12-28 |
| 1316396823 | Shaunak Jaiprakash Intwala | Pharmacist | 330 N Brand Blvd Ste 155, Glendale, CA 91203 | 2016-06-06 |
| 1295117315 | Luis Ernesto Garcia Artiga | Licensed Vocational Nurse | 500 N Central Ave Suite 250, Glendale, CA 91203 | 2015-06-25 |
| Find all providers in zip 91203 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477154573 | Marcus Jang | Nurse Practitioner | 1130 E Colorado St Apt 214, Glendale, CA 91205-2092 | 2020-11-04 |
| 1245870799 | Logan Wellness Advanced Nursing Practice Corp | Nurse Practitioner | 655 N Central Ave # 1754, Glendale, CA 91203-1422 | 2020-01-13 |
| 1164901161 | Jesus Alexie Romero | Nurse Practitioner | 6266 W Blackhawk Dr, Glendale, AZ 85308-6798 | 2018-08-09 |
| 1194226928 | Adina Ramona Boros | Nurse Practitioner | 5625 W Bell Rd # 100, Glendale, AZ 85308-3878 | 2018-02-27 |
| 1740702901 | Barbara Browder | Nurse Practitioner | 17505 N Glendale Ave, Glendale, AZ 85308 | 2017-07-10 |
| 1710413208 | Jhaurel Johnson White | Nurse Practitioner | 1510 S Central Ave Ste 600, Glendale, CA 91204-2548 | 2017-05-03 |
| 1508227687 | Lydia Christine Veratti | Nurse Practitioner | 17505 N 79th Ave Ste 203, Glendale, AZ 85308-8726 | 2016-03-16 |
| 1336536960 | Eric Tubat | Nurse Practitioner | 10329 W Montebello Ave, Glendale, AZ 85307-4313 | 2015-04-21 |
| 1760775837 | Susan E Harrell | Nurse Practitioner | 10270 N 67 Ave, Suite 106, Glendale, AZ 85302-1005 | 2011-05-24 |
| 1427355593 | Zita Schiller | Nurse Practitioner | 15621 N 57th Ave, Glendale, AZ 85306-3009 | 2011-02-24 |
| Find all providers in GLENDALE | ||||
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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.