Mark William Reis, D.C.

Primary specialty

Neurology ChiropractorTaxonomy code 111NN0400X

License

DC20361 Issued in CA

Practice address

1150 White Oak Way
San Carlos, CA 94070-5109

Phone

(650) 593-3500

Fax

(650) 593-3355

NPI assigned

Jul 20, 2006

Sex

Male

Sole proprietor

Yes

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)

Enrolled

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.

• Kotzan Chiropractic

  • Sports Physician Chiropractor
  • San Carlos, CA
  • NPI 1962944652
  NPD (past)

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1194745455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1150 WHITE OAK WAY",
            "city": "SAN CARLOS",
            "state": "CA",
            "postal_code": "940705109",
            "telephone_number": "650-593-3500",
            "fax_number": "650-593-3355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1150 WHITE OAK WAY",
            "city": "SAN CARLOS",
            "state": "CA",
            "postal_code": "940705109",
            "telephone_number": "650-593-3500",
            "fax_number": "650-593-3355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REIS",
        "first_name": "MARK",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-20",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NN0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Neurology",
            "state": "CA",
            "license": "DC20361",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rhonda Renee Rayburn
• Lauren Real
• Cortney Frances Rebholtz
• Mary Frances Reed, MA, MFT INTERN
• Ashley Nicole Reeves, CGC
• Lauren Devlin Reiser Martecchini, ASW
• Sunaina Relan, ASW132982
• Reynalda Retana Alarcon
• Angelina Rey
• Claire Reyes

• Neurology Chiropractor in San Carlos, CA
• Providers in San Carlos, CA by specialty
• Neurology Chiropractor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.