Provider Demographics
NPI:1922296789
Name:MARK A PINTO, MD, INC
Entity Type:Organization
Organization Name:MARK A PINTO, MD, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:PINTO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:559-313-6877
Mailing Address - Street 1:728 E BULLARD AVE
Mailing Address - Street 2:SUITE 105
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93710-5474
Mailing Address - Country:US
Mailing Address - Phone:559-313-6877
Mailing Address - Fax:559-478-8136
Practice Address - Street 1:728 E BULLARD AVE
Practice Address - Street 2:SUITE 105
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93710-5474
Practice Address - Country:US
Practice Address - Phone:559-313-6877
Practice Address - Fax:559-478-8136
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-05
Last Update Date:2016-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA70500207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A705000OtherBLUE CROSS
CA00A705000OtherBLUE SHIELD OF CALIFORNIA
CAZZZ06315ZOtherMEDICARE PTAN
CA00A705000OtherDELTA
CA00A705000OtherDELTA