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Individual
MR. MARK WAKEFIELD
Active
Individual
MR. MARK WAKEFIELD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
525200
CA
Other
Enumeration date
12/11/2015
Last updated
12/17/2015
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