Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RA0401X | Internist - Addiction Medicine | A43785 | CA |
NPI | 1083761670 |
---|---|
Provider Name | Dr. Mark Robert Honzel |
First Address | Beverly Hills, CA 90211-3227 |
Second Address | Beverly Hills, CA 90211-3227 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/01/2007 |
Last Update Date | 08/04/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A437850 | MEDICAL # (01) | CA |
D91497 | (02) | CA |