Provider Demographics
NPI:1497748149
Name:OECHSLI, MARK B (PAC)
Entity Type:Individual
Prefix:MR
First Name:MARK
Middle Name:B
Last Name:OECHSLI
Suffix:
Gender:M
Credentials:PAC
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Mailing Address - Street 1:5738 SKYVIEW WAY
Mailing Address - Street 2:UNIT G
Mailing Address - City:AGOURA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91301
Mailing Address - Country:US
Mailing Address - Phone:818-706-0483
Mailing Address - Fax:
Practice Address - Street 1:4531 ALAMO ST
Practice Address - Street 2:SIERRA VISTA FAMILY MEDICAL CLINIC
Practice Address - City:SIMI VALLEY
Practice Address - State:CA
Practice Address - Zip Code:93063
Practice Address - Country:US
Practice Address - Phone:805-520-3248
Practice Address - Fax:805-579-6082
Is Sole Proprietor?:No
Enumeration Date:2005-08-29
Last Update Date:2023-07-17
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Provider Licenses
StateLicense IDTaxonomies
CAPA14447363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
P89404Medicare UPIN