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General NPI Number Information
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NPI Number | 1083157077
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Entity Type | Individual
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Provider Name | MARK PALCAN PSYD
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Gender | Male
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Dates
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Enumeration Date | 11/23/2016
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Last Update Date | 02/05/2026
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Provider Practice Location Address
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Address Line | 1 DISPENSARY RD
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City | POINT MUGU NAWC
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State | CA
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Zip | 93042-5051
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Country | US
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Telephone | 805-989-8943
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Fax |
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Provider Business Mailing Address
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Address Line | 672 13TH ST BLDG 50
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City | POINT MUGU NAWC
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State | CA
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Zip | 93042-5011
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Country | US
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Telephone |
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 0810005910
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License Number State | VA
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