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Individual
DR. MARK PAUL MAHER
Active
Individual
DR. MARK PAUL MAHER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
79887
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BT609A
PTAN
CA
Enumeration date
01/18/2007
Last updated
07/02/2010
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