Mark David Watanabe, PHARMD, PHD

Primary specialty

Psychiatric PharmacistTaxonomy code 1835P1300X

License

37324 Issued in CA

Practice address

1380 Howard St RM 130
San Francisco, CA 94103

Phone

(415) 255-3659

NPI assigned

Jun 14, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy, Doctor of Pharmacy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• CBHS Pharmacy Services

  • Methadone Clinic
  • San Francisco, CA
  • NPI 1588955074
  NPD (past)
• City & County of San Francisco

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • San Francisco, CA
  • NPI 1548379373
  NPD (past)
• City & County of San Francisco

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • San Francisco, CA
  • NPI 1639272008
  NPD (past)
• City and County of San Francisco

  • Methadone Clinic
  • San Francisco, CA
  • NPI 1578787925
  NPD (past)

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

{
    "created_epoch": "1181779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1526342400000",
    "number": "1104020841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 192912",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941192912",
            "telephone_number": "617-877-9977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1380 HOWARD ST RM 130",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "94103",
            "telephone_number": "415-255-3659"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3905 Mission St",
            "address_purpose": "LOCATION",
            "city": "San Francisco",
            "state": "CA",
            "postal_code": "941121014",
            "country_code": "US",
            "telephone_number": "415-337-2400",
            "fax_number": "415-337-2415",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1563 Mission St Ste A",
            "address_purpose": "LOCATION",
            "city": "San Francisco",
            "state": "CA",
            "postal_code": "941032543",
            "country_code": "US",
            "telephone_number": "628-217-5200",
            "fax_number": "415-553-3900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WATANABE",
        "first_name": "MARK",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "PHARMD, PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-14",
        "last_updated": "2018-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P1300X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Psychiatric",
            "state": "OR",
            "license": "7242",
            "primary": false
        },
        {
            "code": "1835P1300X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Psychiatric",
            "state": "CO",
            "license": "20773",
            "primary": false
        },
        {
            "code": "1835P1300X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Psychiatric",
            "state": "CA",
            "license": "37324",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laorence Wassom, NP-C
• Marissa Wat, RN, MSN
• Aileen Nagako Watanabe, MD
• Brett Watanabe, DDS, MD
• Lauren Watanabe
• Tomohisa Watanabe
• Sarah Watanaskul
• Michael Robert Waterfield, M.D.
• Craig Waterhouse
• Blaire Waterman

• Psychiatric Pharmacist in San Francisco, CA
• Providers in San Francisco, CA by specialty
• Psychiatric Pharmacist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.