Poloway, Mark D
Poloway, Mark D is an sole proprietor health care provider with primary practice located at 2181 El Camino Real Suite 205, Oceanside CA 92054-6222. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Poloway, Mark D can be contacted via phone (760) 612-5490.Contact Information
Primary practice address
2181 El Camino Real Suite 205
Oceanside CA 92054-6222
Phone: (760) 612-5490
Fax: (760) 859-3002
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | PSY8883 | California |
Profile Details
| NPI number | 1457438624 |
|---|---|
| LBN Legal business name | Poloway, Mark D |
| Credentials | PH.D. |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Nov 1st, 2006 |
| Last updated | Dec 28th, 2016 - about 8 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 | 1457438624 | NPPES |
| California | MEDICAID | PK00088830 |
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