Mark Gregory Ellis MD

NPI 1003812744 - Pediatrics - 208000000X

NPI Details
NPI 1003812744
Gender Female
Enumeration Date 06/27/2005
Last Updated 11/09/2011
Entity Type Individual
Active Over 12 years ago
Practice Location
2800 HARRIS ST
EUREKA CA, 95503-4809, US
Phone (707) 445-8416
Fax (707) 445-4182
Business Location
2800 HARRIS ST
EUREKA CA, 95503-4809, US
Phone (707) 445-8416
Fax (707) 445-4182
Toxanomy
Taxonomy Code 208000000X
License State California
License Number G65432
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According to our database, Dr. Mark Gregory Ellis MD NPI is 1003812744, taxonomy code is 208000000X and license number is G65432, license state is located at California. Mark Gregory Ellis MD physically located at 2800 Harris St, Eureka CA, 95503-4809. NPI Number Mark Gregory Ellis MD has the Individual type.

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1003812744 NPI number is provided on an as is basis without warranty of any kind. 1003812744 is maintained by the National Plan & Provider Enumeration System. The contents of Mark Gregory Ellis MD are for informational purposes only.