Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | G36429 | CA |
Y | 111NI0900X | Internist | G36429 | CA |
N | 207RR0500X | Rheumatology | G36429 | CA |
NPI | 1104908292 |
---|---|
Provider Name | Mark A Bookspan |
First Address | Santa Barbara, CA 93150-0706 |
Second Address | Santa Barbara, CA 93105 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/10/2006 |
Last Update Date | 13/08/2018 |