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General NPI Number Information
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NPI Number | 1801870019
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Entity Type | Organization
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Legal Business Name | MARK ONE CORPORATION
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Dates
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Enumeration Date | 12/01/2005
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Last Update Date | 10/05/2015
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Provider Practice Location Address
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Address Line | 812 W MAIN STREET
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City | TURLOCK
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State | CA
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Zip | 95380-4645
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Country | US
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Telephone | 209-667-2828
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Fax | 209-667-4683
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Provider Business Mailing Address
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Address Line | 812 W MAIN STREET
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City | TURLOCK
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State | CA
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Zip | 95380-4645
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Country | US
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Telephone | 209-667-2828
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Fax | 209-667-4683
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Authorized Official
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Title or Position | CEO
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Name | MR. MANEESH BANSAL
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Credential | M.D.
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Telephone | 562-924-9618
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 030000263
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number |
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License Number State | CA
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