Active NPI
Mark Labeau, D.O.
- Internal Medicine Physician
- Encinitas, CA
National Provider Identifier
1104902253
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 20A6565
- Practice address
- 4403 Manchester Ave.
Suite 107
Encinitas, CA 92084 - Phone
- (760) 632-9042
- Fax
- (760) 632-0574
- NPI assigned
- Oct 31, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 20A6565 | CA | Primary |
Addresses
Primary practice location
4403 Manchester Ave.
Suite 107
Encinitas, CA 92084
Mailing address
4403 Manchester Ave.
Suite 107
Encinitas, CA 92084
Phone (760) 632-9042
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective May 1, 2013 through May 1, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6565 | CA | MD | Acupuncturist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162252800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1276560000000",
"number": "1104902253",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4403 MANCHESTER AVE.",
"address_2": "SUITE 107",
"city": "ENCINITAS",
"state": "CA",
"postal_code": "92084",
"telephone_number": "760-632-9042",
"fax_number": "760-632-0574"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4403 MANCHESTER AVE.",
"address_2": "SUITE 107",
"city": "ENCINITAS",
"state": "CA",
"postal_code": "92084",
"telephone_number": "760-632-9042",
"fax_number": "760-632-0574"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LABEAU",
"first_name": "MARK",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-31",
"last_updated": "2010-06-15",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "CA",
"license": "20A6565",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Encinitas, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.