Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | G38301 | CA |
N | 111NI0900X | Internist | G38301 | CA |
Y | 207RC0000X | Internist - Cardiovascular Disease | G38301 | CA |
NPI | 1023094273 |
---|---|
Provider Name | Mark S Zaremba |
First Address | Laguna Hills, CA 92653-5524 |
Second Address | Laguna Hills, CA 92653-5513 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/12/2005 |
Last Update Date | 30/08/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1023094273 | NPI (01) | CA |
A47433 | (02) | CA |
OOG383010 | (05) | CA |