Provider Demographics
NPI:1912542069
Name:NAVAL, MARK ANDREW
Entity Type:Individual
Prefix:MR
First Name:MARK
Middle Name:ANDREW
Last Name:NAVAL
Suffix:
Gender:M
Credentials:
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Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7822 NEWMAN AVE APT C
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92647-6813
Mailing Address - Country:US
Mailing Address - Phone:626-348-7291
Mailing Address - Fax:
Practice Address - Street 1:7822 NEWMAN AVE APT C
Practice Address - Street 2:
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92647-6813
Practice Address - Country:US
Practice Address - Phone:626-348-7291
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-13
Last Update Date:2019-11-13
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant