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Individual

MR. MARK A. BRONSTEIN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
11180 WARNER AVE #163, FOUNTAIN VALLEY, CA 92708
(714) 751-1188
(714) 751-2403
Mailing address
11180 WARNER AVE STE 163, FOUNTAIN VALLEY, CA 92708-7515
(714) 751-1188
(714) 751-2403

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
G44667
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0162028
CA
Enumeration date
11/27/2006
Last updated
02/22/2012
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