Mark Drew Pellegrino
Family Doctor - Geriatric Medicine
441 N Lakeview Ave
Anaheim
, California 92807-3028
Mark Drew Pellegrino
Family Doctor - Geriatric Medicine
441 N Lakeview Ave
Anaheim
, California 92807-3028
(888) 988-2800
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About
Features
Specialties
- Family Doctor - Geriatric Medicine
Languages spoken
- English
Location
First Address
- Mark Drew Pellegrino
- 441 N Lakeview Ave
- Anaheim, CA
- Zip : 92807-3028
- Phone : (888) 988-2800
Second Address
- Mark Drew Pellegrino
- 441 N Lakeview Ave
- Anaheim, CA
- Zip : 92807-3028
- Phone : (888) 988-2800
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207QG0300X | Family Doctor - Geriatric Medicine | G69878 | CA |
National Provider Identifier
| NPI | 1124176912 |
|---|---|
| Provider Name | Mark Drew Pellegrino |
| First Address | Anaheim, CA 92807-3028 |
| Second Address | Anaheim, CA 92807-3028 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 08/01/2007 |
| Last Update Date | 29/11/2021 |
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.