Ellis, Mark Gregory

Ellis, Mark Gregory is an individual health care provider with primary practice located at 2200 Tydd St , Eureka CA 95501-1284. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Ellis, Mark Gregory can be contacted via phone (707) 269-7051.

Contact Information

Primary practice address
2200 Tydd St Eureka CA 95501-1284
Phone: (707) 269-7051
Fax: (707) 269-7054
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X G65432 California

Profile Details

NPI number 1003812744
LBN Legal business name Ellis, Mark Gregory
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 27th, 2005
Last updated Mar 17th, 2018 - about 6 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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