=====================================================
General NPI Number Information
=====================================================
NPI Number | 1912158924
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | MARK E. READER
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/08/2008
-----------------------------------------------------
Last Update Date | 10/08/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 390 PEARSON DR
-----------------------------------------------------
City | PORTERVILLE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 93257-3368
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 559-791-1779
-----------------------------------------------------
Fax | 559-791-9353
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 390 PEARSON DR
-----------------------------------------------------
City | PORTERVILLE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 93257-3368
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 559-791-1779
-----------------------------------------------------
Fax | 559-791-9353
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER/PHYSICIAN
-----------------------------------------------------
Name | DR. MARK E READER
-----------------------------------------------------
Credential | D.O.
-----------------------------------------------------
Telephone | 559-791-1779
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QH0700X
-----------------------------------------------------
Taxonomy Name | Hearing and Speech Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 261QM2500X
-----------------------------------------------------
Taxonomy Name | Medical Specialty Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------