Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0505X | Family Doctor - Adult Medicine | A49222 | CA |
NPI | 1306942073 |
---|---|
Provider Name | Dr. Mark Dressner |
First Address | Long Beach, CA 90806-1620 |
Second Address | Long Beach, CA 90806-1620 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/09/2006 |
Last Update Date | 30/11/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A492220 | (05) | CA |
F52355 | (02) | CA |
FHC11466F | (05) | CA |