# MARK VAISMAN

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1891976189
- **Gender:** Man
- **Credential:** MD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | A38899 | CA | — |
| 207QG0300X | Geriatric Medicine (Family Medicine) Physician | A38899 | CA | — |
| 2085R0202X | Diagnostic Radiology Physician | A38899 | CA | — |
| 2085U0001X | Diagnostic Ultrasound Physician | A38899 | CA | — |
| 208D00000X | General Practice Physician | A38899 | CA | Yes |

## Other

- **Enumeration date:** 11/15/2007
- **Last updated:** 02/08/2013

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 00A388990 | — | CA |