Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | 20A7642 | CA |
N | 207ND0101X | MOHS-Micrographic Surgeon | 20A7642 | CA |
N | 207ND0900X | Dermatopathologist | 20A7642 | CA |
N | 207NP0225X | Pediatric Dermatologist | 20A7642 | CA |
N | 207NS0135X | Procedural Dermatology | 20A7642 | CA |
NPI | 1669413878 |
---|---|
Provider Name | Dr. Mark Kevin Horowitz |
First Address | Torrance, CA 90505-4722 |
Second Address | Torrance, CA 90505-4722 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/06/2006 |
Last Update Date | 17/01/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
20A7642 | OSTEOPATHIC MEDICAL BOARD (01) | CA |
H39927 | (02) | CA |