Mark Sutton MD Inc

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

MARK SUTTON MD INC

Practice address

121 S 7TH Ave Ste a
Barstow, CA 92311-3059

Phone

(760) 256-1004

Fax

(760) 256-1055

NPI assigned

May 10, 2024

Last updated

Jul 16, 2024By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mark Sutton, M.D.NPI 1003841248

Title

Owner/Provider

Phone

(760) 256-1004

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Mark S Sutton, M.D.

  • Dermatology Physician
  • Barstow, CA
  • NPI 1003841248
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1715299200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721088000000",
    "number": "1003664319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 S 7TH AVE",
            "city": "BARSTOW",
            "state": "CA",
            "postal_code": "923113058",
            "telephone_number": "760-256-1004",
            "fax_number": "760-256-1055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 S 7TH AVE STE A",
            "city": "BARSTOW",
            "state": "CA",
            "postal_code": "923113059",
            "telephone_number": "760-256-1004",
            "fax_number": "760-256-1055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK SUTTON MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-10",
        "last_updated": "2024-07-16",
        "certification_date": "2024-07-16",
        "status": "A",
        "authorized_official_last_name": "SUTTON",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "OWNER/PROVIDER",
        "authorized_official_telephone_number": "760-256-1004",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karen L. Manildi
• Michael R Manolescu, M.D.
• Meredith Manuel, LVN
• April Manzo
• Mao H. Hung,M.D.,a Medical Corporation
• Alicia Renee Marquez, RADT I
• Claudia Marroquin
• Shelah Marshall
• Breauna Martin
• Scott Louis Martin, D.C.

• Dermatology Physician in Barstow, CA
• Providers in Barstow, CA by specialty
• Dermatology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.