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Individual

DR. MARK L GARDNER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
475 N FORBES ST, LAKEPORT, CA 95453-4725
(707) 263-6346
(707) 263-5327
Mailing address
475 N FORBES ST, LAKEPORT, CA 95453-4725
(707) 263-6346
(707) 263-5327

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
G73337
CA
207RC0000X
Cardiovascular Disease Physician
ME0065785
FL

Other

Enumeration date
07/10/2006
Last updated
12/14/2017
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