Provider Demographics
NPI:1144375668
Name:MARIN, MARK S (MD)
Entity type:Individual
Prefix:
First Name:MARK
Middle Name:S
Last Name:MARIN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:230 CALIFORNIA ST STE 303
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94111-4362
Mailing Address - Country:US
Mailing Address - Phone:415-397-4295
Mailing Address - Fax:415-397-4595
Practice Address - Street 1:230 CALIFORNIA ST STE 303
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94111-4362
Practice Address - Country:US
Practice Address - Phone:415-397-4295
Practice Address - Fax:415-397-4595
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-24
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA48430207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA943206861OtherTIN
CA943206861OtherTIN