MEDICARE: DR. MARK PALCAN PSYD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	0810005910	VA

General Provider Information

NPI Number	:	1083157077
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARK PALCAN PSYD

Provider Business Mailing Address
First Line	:	672 13TH ST BLDG 50
Second Line	:
City	:	POINT MUGU NAWC
State	:	CA
Zip	:	93042-5011
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1 DISPENSARY RD
Second Line	:
City	:	POINT MUGU NAWC
State	:	CA
Zip	:	93042-5051
Country	:	US
Telephone Number	:	805-989-8943
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/23/2016
Last Update Date	:	02/05/2026

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Directions to “ DR. MARK PALCAN PSYD” Practice Location

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