Healthcare Provider Details

I. General information

NPI: 1508736802
Provider Name (Legal Business Name): MARK ARELLANO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/11/2025
Last Update Date: 11/11/2025
Certification Date: 11/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

433 SOSCOL AVE STE B191
NAPA CA
94559-4040
US

IV. Provider business mailing address

433 SOSCOL AVE STE B191
NAPA CA
94559-4040
US

V. Phone/Fax

Practice location:
  • Phone: 707-224-3131
  • Fax:
Mailing address:
  • Phone: 707-224-3131
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number309249
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: