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1386582039
MARK SHACKER
STANFORD, CA
NPI
1386582039
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2026-03-24
Last Update Date
2026-03-24
Business Address
MARK SHACKER
300 PASTEUR DR # H3591
STANFORD, CA 94305-2200
Phone number: 669-214-1711
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Mailing Address
MARK SHACKER
1527 WHARTON CT
SAN JOSE, CA 95132-2074
Phone number: 669-214-1711
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