Provider Demographics
NPI:1013959253
Name:SUGAR, MARK STEVEN (MD)
Entity type:Individual
Prefix:MR
First Name:MARK
Middle Name:STEVEN
Last Name:SUGAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:28202 CABOT RD STE 105
Mailing Address - Street 2:
Mailing Address - City:LAGUNA NIGUEL
Mailing Address - State:CA
Mailing Address - Zip Code:92677-1247
Mailing Address - Country:US
Mailing Address - Phone:949-364-2900
Mailing Address - Fax:949-365-0117
Practice Address - Street 1:28202 CABOT RD STE 105
Practice Address - Street 2:
Practice Address - City:LAGUNA NIGUEL
Practice Address - State:CA
Practice Address - Zip Code:92677-1247
Practice Address - Country:US
Practice Address - Phone:949-364-2900
Practice Address - Fax:949-365-0117
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2024-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC032628207KA0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA87598Medicare UPIN
CAC32628Medicare ID - Type Unspecified