Madsen, Mark J.

Madsen, Mark J. is an individual health care provider with primary practice located at 1409 E Briggsmore Ave , Modesto CA 95355-2707. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Madsen, Mark J. can be contacted via phone (209) 550-4725.

Contact Information

Primary practice address
1409 E Briggsmore Ave Modesto CA 95355-2707
Phone: (209) 550-4725
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA10310 California

Profile Details

NPI number 1407805757
LBN Legal business name Madsen, Mark J.
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date May 6th, 2006
Last updated Dec 6th, 2012 - about 12 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 1407805757 NPPES
California MEDICAID PA10310

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