Ellis, Mark H.
Ellis, Mark H. is an individual health care provider with primary practice located at 455 S Main St , Orange CA 92868-3835. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatric Allergy/Immunology, which is considered as his primary health care specialty. Ellis, Mark H. can be contacted via phone (714) 289-4511.Contact Information
Primary practice address
455 S Main St
Orange CA 92868-3835
Phone: (714) 289-4511
Fax: (714) 289-4788
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatric Allergy/Immunology | 2080P0201X | C41445 | California |
Profile Details
| NPI number | 1568569424 |
|---|---|
| LBN Legal business name | Ellis, Mark H. |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 20th, 2006 |
| Last updated | Jul 8th, 2007 - about 18 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1568569424 | NPPES |
| California | MEDICAID | 00C414450 |
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