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Individual
MARK D. HABERMAN
Active
Individual
MARK D. HABERMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
G83540
CA
208000000X
Pediatrics Physician
G83540
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G835400
BLUE SHIELD
CA
01
—
110231975
MEDICARE RR
CA
Enumeration date
07/11/2006
Last updated
12/13/2024
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