MEDICARE: ESTE GINELLE MARKS DO

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	208000000X	Pediatrics Physician	20A24127	CA
2	208000000X	Pediatrics Physician	71740	MN

General Provider Information

NPI Number	:	1659934370
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ESTE GINELLE MARKS DO

Provider Business Mailing Address
First Line	:	PO BOX 255228
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95865-5228
Country	:	US
Telephone Number	:	800-470-0071
Fax Number	:	916-854-6769

Provider Business Practice Location Address
First Line	:	8170 LAGUNA BLVD STE 113
Second Line	:
City	:	ELK GROVE
State	:	CA
Zip	:	95758-7902
Country	:	US
Telephone Number	:	916-478-6561
Fax Number	:	916-478-6573

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

Provider Enumeration Date	:	04/18/2019
Last Update Date	:	06/23/2026

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Practice Location Address:

8170 LAGUNA BLVD STE 113
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1275097131 — DR. SPIEN GHAR KOMAK BS, MD
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1932107646 — MICHAEL PATRICK SOTAK M.D.
Practice Location Address:

8170 LAGUNA BLVD , SUITE 114
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1013930866 — THOMAS A BZOSKIE M.D.
Practice Location Address:

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1689685331 — HELENE THUY-HA NGUYEN D.O.
Practice Location Address:

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Directions to “ ESTE GINELLE MARKS DO” Practice Location

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