# MARK H BARAK MD

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1053287755
- **Authorized official:** DIANA CEBALLOS (MANAGEMENT)
- **Authorized official phone:** (909) 596-5900

## Contact information

- **Practice address:** 1911 FOOTHILL BLVD, LA VERNE, CA 91750-3511
- **Practice address phone:** (909) 596-5900
- **Practice address fax:** (909) 596-1655
- **Mailing address:** 1911 FOOTHILL BLVD, LA VERNE, CA 91750-3511
- **Mailing address phone:** (909) 596-5900
- **Mailing address fax:** (909) 596-1655

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207W00000X | Ophthalmology Physician | — | NULL | Yes |
| 207W00000X | Ophthalmology Physician | — | — | Yes |

## Other

- **Enumeration date:** 10/11/2025
- **Last updated:** 10/11/2025