MEDICARE: MARK D. LIPA MD

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	207L00000X	Anesthesiology Physician	30317	CO
2	207L00000X	Anesthesiology Physician	MD429184	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1972573764
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARK D. LIPA MD

Provider Business Mailing Address
First Line	:	33235 OCEAN BRIGHT
Second Line	:
City	:	DANA POINT
State	:	CA
Zip	:	92629-1043
Country	:	US
Telephone Number	:	719-214-6733
Fax Number	:

Provider Business Practice Location Address
First Line	:	33235 OCEAN BRIGHT
Second Line	:
City	:	DANA POINT
State	:	CA
Zip	:	92629-1043
Country	:	US
Telephone Number	:	719-214-6733
Fax Number	:

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

Provider Enumeration Date	:	01/24/2006
Last Update Date	:	09/11/2025

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Directions to “ MARK D. LIPA MD” Practice Location

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