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1407805757
MARK J. MADSEN
MODESTO, CA
NPI
1407805757
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: CA PA10310)
Enumeration Date
2006-05-06
Last Update Date
2012-12-06
Business Address
MARK J. MADSEN PA
1409 E BRIGGSMORE AVE
MODESTO, CA 95355-2707
Phone number: 209-550-4725
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Mailing Address
MARK J. MADSEN PA
600 COFFEE RD
MODESTO, CA 95355-4201
Phone number: 209-521-6097
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