MEDICARE: MARK E. READER

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	261QH0700X	Hearing and Speech Clinic/Center
2	261QM2500X	Medical Specialty Clinic/Center

General Provider Information

NPI Number	:	1912158924
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MARK E. READER

Provider Business Mailing Address
First Line	:	390 PEARSON DR
Second Line	:
City	:	PORTERVILLE
State	:	CA
Zip	:	93257-3368
Country	:	US
Telephone Number	:	559-791-1779
Fax Number	:	559-791-9353

Provider Business Practice Location Address
First Line	:	390 PEARSON DR
Second Line	:
City	:	PORTERVILLE
State	:	CA
Zip	:	93257-3368
Country	:	US
Telephone Number	:	559-791-1779
Fax Number	:	559-791-9353

Authorized Official
Title or Position	:	OWNER/PHYSICIAN
Name	:	DR. MARK E READER
Credential	:	D.O.
Telephone Number	:	559-791-1779

Provider Enumeration Date	:	10/08/2008
Last Update Date	:	10/08/2008

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Directions to “MARK E. READER ” Practice Location

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