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Individual

MARK S SUTTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
121 S 7TH AVE STE A, BARSTOW, CA 92311-3059
(760) 818-4228
(760) 256-1055
Mailing address
930 W MAIN ST, BARSTOW, CA 92311-2654
(760) 256-1004
(760) 256-1055

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
G27354
CA
207Q00000X
Family Medicine Physician
G72354
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00G723540
CA
Enumeration date
07/12/2006
Last updated
12/19/2024
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