Provider Demographics
NPI:1629031711
Name:POCINICH, MARK ANDREW (ATC)
Entity type:Individual
Prefix:MR
First Name:MARK
Middle Name:ANDREW
Last Name:POCINICH
Suffix:
Gender:M
Credentials:ATC
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Mailing Address - Street 1:2923 SILVA ST
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90712-2936
Mailing Address - Country:US
Mailing Address - Phone:562-408-3569
Mailing Address - Fax:
Practice Address - Street 1:3501 WATTS WAY
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90089-0604
Practice Address - Country:US
Practice Address - Phone:213-740-5845
Practice Address - Fax:213-740-0504
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-10
Last Update Date:2007-07-08
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer