Provider Demographics
NPI:1942521570
Name:MARK B. SENDER, M.D., INC.
Entity Type:Organization
Organization Name:MARK B. SENDER, M.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:B
Authorized Official - Last Name:SENDER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:661-254-2777
Mailing Address - Street 1:23928 LYONS AVE
Mailing Address - Street 2:SUITE 202
Mailing Address - City:NEWHALL
Mailing Address - State:CA
Mailing Address - Zip Code:91321-2409
Mailing Address - Country:US
Mailing Address - Phone:661-254-2777
Mailing Address - Fax:303-565-5706
Practice Address - Street 1:23928 LYONS AVE
Practice Address - Street 2:STE 202
Practice Address - City:NEWHALL
Practice Address - State:CA
Practice Address - Zip Code:91321-2454
Practice Address - Country:US
Practice Address - Phone:661-254-2777
Practice Address - Fax:303-565-5706
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-17
Last Update Date:2010-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG48510174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1013097534OtherNPI
CA00G485100Medicaid
CAG48510AMedicare PIN
CA00G485100Medicaid