Avon, Mark R.

Avon, Mark R. is an sole proprietor health care provider with primary practice located at 5201 Norris Canyon Rd Ste 210 , San Ramon CA 94583-5405. He recently has only one registered license in Allopathic & Osteopathic Physicians / Urology, which is considered as his primary health care specialty. Avon, Mark R. can be contacted via phone (925) 830-1140.

Contact Information

Primary practice address
5201 Norris Canyon Rd Ste 210 San Ramon CA 94583-5405
Phone: (925) 830-1140
Fax: (925) 973-0976
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Urology 208800000X A43035 California

Profile Details

NPI number 1689711756
LBN Legal business name Avon, Mark R.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 30th, 2007
Last updated Aug 17th, 2021 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1689711756 NPPES
California Other A43035 CA MEDICAL LICENSE
California MEDICAID 00A430350 CA MEDICAL LICENSE

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