Healthcare Provider Details

I. General information

NPI: 1497963938
Provider Name (Legal Business Name): DAVID MARK REKAR M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/18/2007
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4789 VINELAND AVE STE 101
NORTH HOLLYWOOD CA
91602-3518
US

IV. Provider business mailing address

4789 VINELAND AVE STE 101
NORTH HOLLYWOOD CA
91602-3518
US

V. Phone/Fax

Practice location:
  • Phone: 323-436-0303
  • Fax: 323-436-0306
Mailing address:
  • Phone: 323-436-0303
  • Fax: 323-436-0306

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberG50815
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberG50815
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code2081S0010X
TaxonomySports Medicine (Physical Medicine & Rehabilitation) Physician
License NumberG50815
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: