Individual
MARK DOUGLAS BISHOP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2178 JOHNSON AVE, SAN LUIS OBISPO, CA 93401-4535
(805) 781-4711
Mailing address
10935 SAN MARCOS RD, ATASCADERO, CA 93422-2185
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
509248
CA
Other
Enumeration date
12/05/2006
Last updated
07/08/2007
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