Provider Demographics
NPI:1023036670
Name:GERARD, MARK A (MD)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:A
Last Name:GERARD
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:201 S BUENA VISTA ST
Mailing Address - Street 2:SUITE # 250
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91505-4569
Mailing Address - Country:US
Mailing Address - Phone:818-562-3200
Mailing Address - Fax:818-562-3205
Practice Address - Street 1:201 S BUENA VISTA ST
Practice Address - Street 2:SUITE # 250
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91505-4569
Practice Address - Country:US
Practice Address - Phone:818-562-3200
Practice Address - Fax:818-562-3205
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2023-03-07
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Provider Licenses
StateLicense IDTaxonomies
CAG61489207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CABG1178474OtherDEA
CAE48506Medicare UPIN