Individual
MARK JAYNES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
9616 SHIMIZU RIVER CIR, FOUNTAIN VALLEY, CA 92708-7243
(714) 273-4414
Mailing address
9616 SHIMIZU RIVER CIR, FOUNTAIN VALLEY, CA 92708-7243
(714) 273-4414
Taxonomy
Speciality
Code
Description
License number
State
163WE0003X
Emergency Registered Nurse
Primary
710415
CA
Other
Enumeration date
07/21/2016
Last updated
07/21/2016
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