Homicz, Mark R

Homicz, Mark R is an individual health care provider with primary practice located at 1701 4Th St Ste 120 , Santa Rosa CA 95404-3661. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Otolaryngology, Allopathic & Osteopathic Physicians / Plastic Surgery within the Head & Neck. Allopathic & Osteopathic Physicians / Otolaryngology is his primary health care specialty. Homicz, Mark R can be contacted via phone (707) 523-7025.

Contact Information

Primary practice address
1701 4Th St Ste 120 Santa Rosa CA 95404-3661
Phone: (707) 523-7025
Fax: (707) 523-3024
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Otolaryngology 207Y00000X A70413 California
Allopathic & Osteopathic Physicians / Plastic Surgery within the Head & Neck 207YX0007X A70413 California

Profile Details

NPI number 1336198449
LBN Legal business name Homicz, Mark R
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 8th, 2006
Last updated Feb 7th, 2012 - about 13 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 1336198449 NPPES
California Other 00A704130 BLUE SHIELD OF CALIFORNIA
California Other P00933198 BLUE SHIELD OF CALIFORNIA

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