Individual
MARK R. AVON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5201 NORRIS CANYON RD STE 210, SAN RAMON, CA 94583-5405
(925) 830-1140
(925) 973-0976
Mailing address
1450 TREAT BLVD # 300, WALNUT CREEK, CA 94597-2168
(925) 952-2828
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
A43035
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A430350
—
CA
01
—
A43035
CA MEDICAL LICENSE
CA
Enumeration date
01/30/2007
Last updated
08/17/2021
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