Provider Demographics
NPI:1649363334
Name:READER, MARK E (DO)
Entity type:Individual
Prefix:
First Name:MARK
Middle Name:E
Last Name:READER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:390 N. PEARSON DRIVE
Mailing Address - Street 2:
Mailing Address - City:PORTERVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:93257
Mailing Address - Country:US
Mailing Address - Phone:559-791-1779
Mailing Address - Fax:559-791-9353
Practice Address - Street 1:390 N. PEARSON DRIVE
Practice Address - Street 2:
Practice Address - City:PORTERVILLE
Practice Address - State:CA
Practice Address - Zip Code:93257
Practice Address - Country:US
Practice Address - Phone:559-791-1779
Practice Address - Fax:559-791-9353
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2009-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A8888207Y00000X, 207YX0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
No207YX0901XAllopathic & Osteopathic PhysiciansOtolaryngologyOtology & Neurotology
Provider Identifiers
StateIdentifier IDID TypeIssuer
421387379OtherTRICARE
4536696OtherAETNA
020A88880OtherBLUE SHIELD
421387379OtherBLUE CROSS
4213873790OtherADVANTEK
421387379AOtherHEALTHNET
CA00AX88880Medicaid
421387379AOtherHEALTHNET
CA020A88880Medicare PIN