MEDICARE: MARK R STOKES D.C.

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	111N00000X	Chiropractor	DC10691	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	DC0106910	OTHER	CA	BLUE SHIELD

General Provider Information

NPI Number	:	1487735288
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARK R STOKES D.C.

Provider Business Mailing Address
First Line	:	15520 ROCKFIELD BLVD A200
Second Line	:
City	:	IRVINE
State	:	CA
Zip	:	92618-6705
Country	:	US
Telephone Number	:	949-598-9999
Fax Number	:	949-598-9990

Provider Business Practice Location Address
First Line	:	3325 PALO VERDE AVE
Second Line	:	204
City	:	LONG BEACH
State	:	CA
Zip	:	90808-4132
Country	:	US
Telephone Number	:	562-497-8787
Fax Number	:	562-497-8790

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

Provider Enumeration Date	:	10/18/2006
Last Update Date	:	10/16/2015

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Directions to “ MARK R STOKES D.C.” Practice Location

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