MEDICARE: DR. MARK MICHAEL DECHTER M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	G31615	CA

General Provider Information

NPI Number	:	1174598478
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARK MICHAEL DECHTER M.D.

Provider Business Mailing Address
First Line	:	7301 MEDICAL CENTER DR
Second Line	:	SUITE 500
City	:	WEST HILLS
State	:	CA
Zip	:	91307-1904
Country	:	US
Telephone Number	:	818-226-3666
Fax Number	:	818-992-6853

Provider Business Practice Location Address
First Line	:	7301 MEDICAL CENTER DR
Second Line	:	SUITE 500
City	:	WEST HILLS
State	:	CA
Zip	:	91307-1904
Country	:	US
Telephone Number	:	818-226-3666
Fax Number	:	818-992-6853

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/21/2006
Last Update Date	:	02/26/2013

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