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General NPI Number Information
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NPI Number | 1033795638
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Entity Type | Individual
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Provider Name | MARK CHARLES DARWELL CMP
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Gender | Male
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Dates
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Enumeration Date | 03/23/2021
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Last Update Date | 03/23/2021
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Provider Practice Location Address
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Address Line | 8760 CUYAMACA STREET SUITE 203
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City | SANTEE
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State | CA
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Zip | 92071
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Country | US
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Telephone | 619-258-1011
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Fax |
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Provider Business Mailing Address
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Address Line | 12530 ROYAL ROAD SPACE 56
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City | EL CAJON
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State | CA
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Zip | 92021
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Country | US
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Telephone | 619-592-9872
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 44021
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License Number State | CA
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