Healthcare Provider Details

I. General information

NPI: 1912158924
Provider Name (Legal Business Name): MARK E. READER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/08/2008
Last Update Date: 10/08/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

390 PEARSON DR
PORTERVILLE CA
93257-3368
US

IV. Provider business mailing address

390 PEARSON DR
PORTERVILLE CA
93257-3368
US

V. Phone/Fax

Practice location:
  • Phone: 559-791-1779
  • Fax: 559-791-9353
Mailing address:
  • Phone: 559-791-1779
  • Fax: 559-791-9353

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QH0700X
TaxonomyHearing and Speech Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. MARK E READER
Title or Position: OWNER/PHYSICIAN
Credential: D.O.
Phone: 559-791-1779