Shelly, Mark R

Shelly, Mark R is an individual health care provider with primary practice located at 17609 Ventura Blvd Ste 210, Encino CA 91316-5123. He recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery, which is considered as his primary health care specialty. Shelly, Mark R can be contacted via phone (818) 708-7668.

Contact Information

Primary practice address
17609 Ventura Blvd Ste 210 Encino CA 91316-5123
Phone: (818) 708-7668
Fax: (818) 708-9668
Website:
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Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery 213ES0103X E3427 California

Profile Details

NPI number 1902922149
LBN Legal business name Shelly, Mark R
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 21st, 2007
Last updated Feb 14th, 2017 - 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.

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