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General NPI Number Information
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NPI Number | 1104803683
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Entity Type | Individual
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Provider Name | MARK NACHMAN MD
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Gender | Male
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Dates
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Enumeration Date | 12/27/2005
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Last Update Date | 04/19/2021
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Provider Practice Location Address
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Address Line | 1301 20TH ST STE 290
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City | SANTA MONICA
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State | CA
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Zip | 90404-2053
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Country | US
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Telephone | 310-315-0111
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Fax | 310-315-0110
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Provider Business Mailing Address
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Address Line | 1301 20TH ST STE 290
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City | SANTA MONICA
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State | CA
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Zip | 90404-2053
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Country | US
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Telephone | 310-315-0111
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Fax | 310-315-0110
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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 | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | G27424
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | G27424
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License Number State | CA
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