Individual
DR. MARK S MINKES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
11480 BROOKSHIRE AVE, SUITE 111, DOWNEY, CA 90241-5010
(562) 904-1651
(562) 904-1656
Mailing address
11480 BROOKSHIRE AVE, SUITE 111, DOWNEY, CA 90241-5010
(562) 904-1651
(562) 904-1656
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
G38259
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0004024011
AETNA
CA
01
—
990004307
PALMETTO RAILROAD MEDICARE
CA
01
—
GR0080690
MEDI-CAL
CA
05
—
GR0080690
—
CA
01
—
ZZZ54573Z
BLUE SHIELD
CA
Enumeration date
05/09/2006
Last updated
07/24/2008
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