Individual
MARK CROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
560 W PUTNAM AVE, PORTERVILLE, CA 93257-3269
(559) 781-1665
(559) 781-6036
Mailing address
2050 S BLOSSER RD, SANTA MARIA, CA 93458-7310
(805) 361-8017
(805) 361-8097
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
19505
CA
363AM0700X
Medical Physician Assistant
Primary
19505
CA
363AM0700X
Medical Physician Assistant
2322
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
83821368
—
CA
Enumeration date
03/02/2007
Last updated
12/01/2025
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