Organization
M. MARK MOFID, MD A PROFESSIONAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MEHRDAD MARK MOFID M.D. (PRESIDENT)
(858) 909-9000
Entity
Organization
Contact information
Practice address
4150 REGENTS PARK ROW, SUITE 300, LA JOLLA, CA 92037-9124
(858) 909-9000
(858) 909-9009
Mailing address
4150 REGENTS PARK ROW, SUITE 300, LA JOLLA, CA 92037-9124
(858) 909-9000
(858) 909-9009
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
A83432
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A834320
—
CA
Enumeration date
12/13/2005
Last updated
05/15/2009
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