| Mark Lane | |
|
2520 Mark Ln Costa Mesa CA 92626-6701 | |
| (800) 866-0860 | |
| Not Available |
| Full Name | Mark Lane |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 2520 Mark Ln, Costa Mesa, California |
| Authorized Official Name and Position | Deena Ombres (PRIVACY OFFICER) |
| Authorized Official Contact | 5023942387 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mark Lane 9901 Linn Station Rd Louisville KY 40223-3808 Ph: (800) 866-0860 | Mark Lane 2520 Mark Ln Costa Mesa CA 92626-6701 Ph: (800) 866-0860 |
| NPI Number | 1376840314 |
|---|---|
| Provider Enumeration Date | 02/25/2011 |
| Last Update Date | 02/25/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376840314 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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