Organization
MARK A KALLGREN MD PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK KALLGREN MD (OWNER)
(503) 805-6114
Entity
Organization
Contact information
Practice address
250 E DUNLAP AVE, PHOENIX, AZ 85020-2825
(602) 943-2381
Mailing address
PO BOX 7096, STOCKTON, CA 95267-0096
(209) 956-7732
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
Other
Enumeration date
04/26/2023
Last updated
04/26/2023
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