Individual
MARK WAINER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2900 CHANTICLEER AVE, SANTA CRUZ, CA 95065-1816
(831) 477-2325
Mailing address
PO BOX 1833, SANTA CRUZ, CA 95061-1833
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
A24807
CA
Other
Enumeration date
01/20/2006
Last updated
01/10/2008
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