Provider Demographics
NPI:1780238907
Name:PARTAIN, MARK I (AUD)
Entity type:Individual
Prefix:
First Name:MARK
Middle Name:I
Last Name:PARTAIN
Suffix:
Gender:M
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2730 WILSHIRE BLVD STE 450
Mailing Address - Street 2:
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90403-4742
Mailing Address - Country:US
Mailing Address - Phone:310-586-5533
Mailing Address - Fax:
Practice Address - Street 1:2730 WILSHIRE BLVD STE 450
Practice Address - Street 2:
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90403-4742
Practice Address - Country:US
Practice Address - Phone:310-586-5533
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-25
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAU3428231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist