Healthcare Provider Details

I. General information

NPI: 1306942073
Provider Name (Legal Business Name): MARK DRESSNER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/16/2006
Last Update Date: 11/30/2021
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

455 E COLUMBIA ST SUITE 201-206
LONG BEACH CA
90806-1620
US

IV. Provider business mailing address

455 E COLUMBIA ST STE 201-6
LONG BEACH CA
90806-1620
US

V. Phone/Fax

Practice location:
  • Phone: 562-933-0400
  • Fax: 562-933-0489
Mailing address:
  • Phone: 562-933-0400
  • Fax: 562-933-0489

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License NumberA49222
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: