Provider Demographics
NPI:1023094273
Name:ZAREMBA, MARK S (MD)
Entity type:Individual
Prefix:
First Name:MARK
Middle Name:S
Last Name:ZAREMBA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:25401 CABOT RD
Mailing Address - Street 2:SUITE 107
Mailing Address - City:LAGUNA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:92653-5524
Mailing Address - Country:US
Mailing Address - Phone:949-273-8085
Mailing Address - Fax:949-273-8088
Practice Address - Street 1:25401 CABOT RD
Practice Address - Street 2:SUITE 107
Practice Address - City:LAGUNA HILLS
Practice Address - State:CA
Practice Address - Zip Code:92653-5513
Practice Address - Country:US
Practice Address - Phone:949-273-8085
Practice Address - Fax:949-273-8088
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-20
Last Update Date:2010-08-30
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAG38301207R00000X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAOOG383010Medicaid
CA1023094273OtherNPI
CA1023094273OtherNPI
CAOOG383010Medicaid