Individual
DR. MARK LAVERNE JANZEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
10800 MAGNOLIA AVENUE,, KAISER PERMANENTE RIVERSIDE MEDICAL CENTER, RIVERSIDE, CA 92505
(440) 781-0931
Mailing address
10800 MAGNOLIA AVENUE, MOB1, 2ND FLOOR, MODULE 216, KAISER PERMANENTE RIVERSIDE MEDICAL CENTER, RIVERSIDE, CA 92505
(440) 781-0931
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
089484
OH
2086S0127X
Trauma Surgery Physician
089484
OH
2086S0129X
Vascular Surgery Physician
Primary
A90203
CA
Other
Enumeration date
04/27/2007
Last updated
01/27/2017
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