Organization
MARK E EASTHAM M D A PROFESSIONAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK EDWARD EASTHAM M.D. (MEDICAL DIRECTOR)
(408) 315-1814
Entity
Organization
Contact information
Practice address
250 BON AIR RD, GREENBRAE, CA 94904-1702
(415) 925-7220
Mailing address
2505 SAMARITAN DR STE 508, SAN JOSE, CA 95124-4014
(408) 315-1814
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
G65379
CA
Other
Enumeration date
07/02/2009
Last updated
07/17/2009
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