Mark Alan Netherda, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

G67595 Issued in CA

Practice address

625 5TH St
Santa Rosa, CA 95404-4428

Phone

(707) 565-7400

NPI assigned

May 16, 2007

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)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1179273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1297123200000",
    "number": "1225245657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 5TH ST",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954044428",
            "telephone_number": "707-565-4400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 5TH ST",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954044428",
            "telephone_number": "707-565-7400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NETHERDA",
        "first_name": "MARK",
        "middle_name": "ALAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-16",
        "last_updated": "2011-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G67595",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebecca Howe Nelson, RPT
• Thomas Nelson
• Nephrology Associates
• Marie Nersesian, MA
• Christina Elizabeth Ness, L.AC.
• Robynne Neuhaus, B.S. OTR/L
• Neuropsychological Assoc of Ca-a Professional Psychological Corp (Neuropsychological Associates Of CA)
• Carol Neves
• New Directions Adolescent Services, Inc
• New Directions Medical Center Inc

• Family Medicine Physician in Santa Rosa, CA
• Providers in Santa Rosa, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2011; 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.