Healthcare Provider Details

I. General information

NPI: 1821242165
Provider Name (Legal Business Name): MARK PINTO M.S., C.G.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/13/2008
Last Update Date: 11/13/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

310 N SAN VICENTE BLVD 3RD FLOOR
WEST HOLLYWOOD CA
90048-1810
US

IV. Provider business mailing address

310 N SAN VICENTE BLVD 3RD FLOOR
WEST HOLLYWOOD CA
90048-1810
US

V. Phone/Fax

Practice location:
  • Phone: 323-423-9373
  • Fax: 323-423-9399
Mailing address:
  • Phone: 323-423-9373
  • Fax: 323-423-9399

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code170300000X
TaxonomyGenetic Counselor (M.S.)
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: