Individual
DR. MARK FORD POMERANTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2271 S. DEPOT STREET, SANTA MARIA, CA 93455
(805) 922-0561
Mailing address
1400 E. CHURCH STREET, ATTENTION: MEDICAL STAFF OFFICE, SANTA MARIA, CA 93454
(805) 739-3954
(805) 739-3060
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
G48284
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G482840
BLUE SHIELD
CA
Enumeration date
10/06/2006
Last updated
01/08/2019
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