Individual
MARK JASON JOEL SAN JOSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
101 THE CITY DR S, ORANGE, CA 92868-3201
(800) 465-3203
Mailing address
UC IRVINE MEDICAL CENTER, 101 THE CITY DRIVE SOUTH, ORANGE, CA 92868-3201
(800) 465-3203
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
95027777
CA
Other
Enumeration date
10/23/2023
Last updated
09/27/2024
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