Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | E1305 | CA |
Y | 222Z00000X | Podiatrist | E1305 | CA |
N | 213EP1101X | Primary Podiatric Medicine | E1305 | CA |
N | 213ES0131X | Foot Surgery | E1305 | CA |
NPI | 1356667943 |
---|---|
Provider Name | Dr. Martin Alan Marks |
First Address | Compton, CA 90221-3406 |
Second Address | Compton, CA 90221-3406 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/04/2010 |
Last Update Date | 08/04/2010 |