Healthcare Provider Details

I. General information

NPI: 1134193469
Provider Name (Legal Business Name): MARK E HIGGINS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/14/2006
Last Update Date: 12/04/2025
Certification Date: 12/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

45 CASTRO ST STE 421
SAN FRANCISCO CA
94114-1031
US

IV. Provider business mailing address

PO BOX 276950
SACRAMENTO CA
95827-6950
US

V. Phone/Fax

Practice location:
  • Phone: 415-600-4900
  • Fax: 415-369-1314
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA60868
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: