Dr. Mark Grant Medinnus
Dentist - General Practice
9024 Sniktaw Ln
Fort Jones
, California 96032-9408
Dr. Mark Grant Medinnus
Dentist - General Practice
9024 Sniktaw Ln
Fort Jones
, California 96032-9408
(530) 467-3517
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About
Features
Specialties
- General Practice
Languages spoken
- English
Location
First Address
- Dr. Mark Grant Medinnus
- Po Box 302
- Mad River, CA
- Zip : 95552-4302
- Phone : (530) 467-3517
Second Address
- Dr. Mark Grant Medinnus
- 9024 Sniktaw Ln
- Fort Jones, CA
- Zip : 96032-9408
- Phone : (530) 468-4470
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 1223G0001X | General Practice | 33630 | CA |
| Y | 213EG0000X | General Practice | 33630 | CA |
National Provider Identifier
| NPI | 1003065988 |
|---|---|
| Provider Name | Dr. Mark Grant Medinnus |
| First Address | Mad River, CA 95552-4302 |
| Second Address | Fort Jones, CA 96032-9408 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 16/09/2008 |
| Last Update Date | 19/03/2016 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.