Provider Demographics
NPI:1467561704
Name:D'ESPOSITO, MARK THOMAS (MD)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:THOMAS
Last Name:D'ESPOSITO
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:HELEN WILLS NEUROSCIENCE INSTITUTE
Mailing Address - Street 2:132 BARKER HALL
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94720-3190
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:150 MUIR RD
Practice Address - Street 2:NORTHERN CALIFORNIA HEALTH CARE SYSTEM
Practice Address - City:MARTINEZ
Practice Address - State:CA
Practice Address - Zip Code:94553-4668
Practice Address - Country:US
Practice Address - Phone:925-372-2059
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2007-07-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAG854742084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology