Provider Demographics
NPI:1760401343
Name:OEHLSCHLAEGER, MARK NATHAN (DC)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:NATHAN
Last Name:OEHLSCHLAEGER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:49346 ROAD 426 STE 3
Mailing Address - Street 2:
Mailing Address - City:OAKHURST
Mailing Address - State:CA
Mailing Address - Zip Code:93644-9016
Mailing Address - Country:US
Mailing Address - Phone:559-683-5001
Mailing Address - Fax:559-683-5303
Practice Address - Street 1:49346 ROAD 426 STE 3
Practice Address - Street 2:
Practice Address - City:OAKHURST
Practice Address - State:CA
Practice Address - Zip Code:93644-9016
Practice Address - Country:US
Practice Address - Phone:559-683-5001
Practice Address - Fax:559-683-5303
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC28409111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAU91827Medicare UPIN
CADC0284090Medicare ID - Type Unspecified