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1851679674
LISA SUSAN MARK
LOS ANGELES, CA
NPI
1851679674
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363A00000X Physician Assistant
(Licence: CA PA12333)
Enumeration Date
2011-07-27
Last Update Date
2016-03-08
Business Address
-- LISA SUSAN MARK
1441 EASTLAKE AVE NOR 8302E
LOS ANGELES, CA 90089-0112
Phone number: 323-865-3000
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Mailing Address
-- LISA SUSAN MARK
PO BOX 31309
LOS ANGELES, CA 90031-0309
Phone number: 323-865-3105
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