Mako, Mark

Mako, Mark is an individual health care provider with primary practice located at 2585 Cochran St Suite A, Simi Valley CA 93065-2602. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as his primary health care specialty. Mako, Mark can be contacted via phone (805) 584-0001.

Contact Information

Primary practice address
2585 Cochran St Suite A Simi Valley CA 93065-2602
Phone: (805) 584-0001
Fax: (805) 527-9135
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X PT 15347 California

Profile Details

NPI number 1013961275
LBN Legal business name Mako, Mark
Credentials P.T., O.C.S.
Entity Individual
Sole proprietor 1 No
Enumeration date May 20th, 2006
Last updated Sep 20th, 2007 - about 17 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 1013961275 NPPES
California Other 77057605493065A002 TRICARE
California Other PT00015347 TRICARE
California Other 0PT153470 TRICARE

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