Provider Demographics
NPI:1255089363
Name:MARK MORISHIGE MD INC
Entity type:Organization
Organization Name:MARK MORISHIGE MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DR
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:MORISHIGE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:408-356-0444
Mailing Address - Street 1:763 ALTOS OAKS DR STE 2
Mailing Address - Street 2:
Mailing Address - City:LOS ALTOS
Mailing Address - State:CA
Mailing Address - Zip Code:94024-5400
Mailing Address - Country:US
Mailing Address - Phone:408-356-0444
Mailing Address - Fax:408-358-5125
Practice Address - Street 1:763 ALTOS OAKS DR STE 2
Practice Address - Street 2:
Practice Address - City:LOS ALTOS
Practice Address - State:CA
Practice Address - Zip Code:94024-5400
Practice Address - Country:US
Practice Address - Phone:408-356-0444
Practice Address - Fax:408-358-5125
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-17
Last Update Date:2023-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty