Mark Geoffrey Wahrenbrock, M.D., PH.D.

Primary specialty

Clinical Pathology PhysicianTaxonomy code 207ZC0006X

License

A158210 Issued in CA

Practice address

8901 Activity Rd Ste 205
San Diego, CA 92126-4436

Phone

(888) 992-7555

NPI assigned

Jul 6, 2013

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine, Doctor of Philosophy

State licenses

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/18492/brand/1/csg/1/fhir/r4

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

{
    "created_epoch": "1373068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617148800000",
    "number": "1104267145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8901 ACTIVITY RD STE 205",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921264436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8901 ACTIVITY RD STE 205",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921264436",
            "telephone_number": "888-992-7555"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11401 Bloomfield Ave",
            "address_purpose": "LOCATION",
            "city": "Norwalk",
            "state": "CA",
            "postal_code": "906502015",
            "country_code": "US",
            "telephone_number": "562-651-4151",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WAHRENBROCK",
        "first_name": "MARK",
        "middle_name": "GEOFFREY",
        "credential": "M.D., PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-07-06",
        "last_updated": "2021-03-31",
        "certification_date": "2021-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZC0006X",
            "taxonomy_group": "",
            "desc": "Pathology, Clinical Pathology",
            "state": "CA",
            "license": "A158210",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Frederick Wahlig, LCSW
• Nancy Jean Wahlig, LCSW
• Tamara Ann Wahlin, P.A.
• Christine Elizabeth Wahlmeier, DO
• Udo Wahn, MD
• Shannon San San Wai
• Victoria Ann Waidley, MD
• Trinity Wailes
• John Wainwright
• Paula A Waisman, PH.D.

• Clinical Pathology Physician in San Diego, CA
• Providers in San Diego, CA by specialty
• Clinical Pathology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2021; 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.