Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0106X | Orthopaedic Hand Surgeon | G42815 | CA |
N | 208200000X | Surgeon | G42815 | CA |
N | 208600000X | Surgeon | G42815 | CA |
NPI | 1114060126 |
---|---|
Provider Name | Mark Rechnic |
First Address | La Jolla, CA 92037-5138 |
Second Address | La Jolla, CA 92037-5138 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/02/2007 |
Last Update Date | 29/07/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A92368 | (02) | CA |