Individual
MR. MARK SCOTT MISTAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
815 FLEMING COURT, VALLEJO, CA 94591
(707) 400-4373
Mailing address
815 FLEMING COURT, VALLEJO, CA 94591
(707) 400-4373
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
Primary
451493
CA
Other
Enumeration date
01/13/2021
Last updated
01/13/2021
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