| Dr Mark J Freeman, MD | |
|
15322 Lakeshore Dr, Ste 101, Clearlake, CA 95422-9815 | |
| (707) 995-1362 | |
| (707) 995-7057 |
| Full Name | Dr Mark J Freeman |
|---|---|
| Gender | Male |
| Speciality | Family Medicine |
| Location | 15322 Lakeshore Dr, Clearlake, California |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801898929 | NPI | - | NPPES |
| 00G476880 | Medicaid | CA | |
| P00660683 | Other | CA | MEDICARE RAILROAD # |
| 080150278 | Other | MEDICARE RAILROAD # |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | G47688 (California) | Primary |
| Entity Name | Adventist Health Physicians Network |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1063718583 PECOS PAC ID: 3274580972 Enrollment ID: O20050407000633 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Mark J Freeman, MD 15322 Lakeshore Dr, Ste 101, Clearlake, CA 95422-9815 Ph: (707) 995-1362 | Dr Mark J Freeman, MD 15322 Lakeshore Dr, Ste 101, Clearlake, CA 95422-9815 Ph: (707) 995-1362 |
Gail Marquette, FNP Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 15230 Lakeshore Dr, Clearlake, CA 95422 Phone: 707-995-4500 Fax: 707-994-2401 | |
Dr. Jerry Edward Douglas, MD Family Medicine Medicare: Medicare Enrolled Practice Location: 15322 Lakeshore Dr, Suite 202, Clearlake, CA 95422 Phone: 707-994-0303 Fax: 707-995-9447 | |
Sonja Derose, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 15230 Lakeshore Dr, Clearlake, CA 95422 Phone: 707-995-4500 | |
Wolfgang Schug, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 15230 Lakeshore Dr, Clearlake, CA 95422 Phone: 707-995-4500 Fax: 707-994-2401 | |
Siqi Ma, DO Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 15230 Lakeshore Dr, Clearlake, CA 95422 Phone: 707-995-4500 | |
Dr. John Alden Weeks, M.D. Family Medicine Medicare: Medicare Enrolled Practice Location: 15230 Lakeshore Dr, Suite 101, Clearlake, CA 95422 Phone: 707-994-7377 Fax: 707-994-9456 |