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Individual
MARK POWELL
Active
Individual
MARK POWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
G70304
CA
208000000X
Pediatrics Physician
Primary
G70304
CA
Other
Enumeration date
11/03/2006
Last updated
09/13/2019
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