Mark Olcott, M.D., Inc.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

Legal business name

MARK OLCOTT, M.D., INC.

Doing business as

Mission Medical Support

Practice address

720 E San Ysidro Blvd
San Ysidro, CA 92173-3101

Phone

(619) 261-7427

NPI assigned

Feb 25, 2019

Organization subpart

No

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

Authorized official

Name

Dr. Mark Vernon Olcott, MD

Title

Owner/President

Phone

(619) 795-0102

Specialties & licenses 1

Addresses

Other names 1

• Mission Medical Support Doing business as

Tax ID family

Mark Olcott MD Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Mark Olcott, M.D., Inc.

  • Emergency Medicine Physician
  • San Diego, CA
  • NPI 1962947317
  NPD tax ID

Locations

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

{
    "created_epoch": "1551052800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1551052800000",
    "number": "1366909533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 E SAN YSIDRO BLVD",
            "city": "SAN YSIDRO",
            "state": "CA",
            "postal_code": "921733101",
            "telephone_number": "619-261-7427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 E SAN YSIDRO BLVD",
            "city": "SAN YSIDRO",
            "state": "CA",
            "postal_code": "921733101",
            "telephone_number": "619-261-7427"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK OLCOTT, M.D., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-25",
        "last_updated": "2019-02-25",
        "status": "A",
        "authorized_official_last_name": "OLCOTT",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "VERNON",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "619-795-0102",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mission Medical Support",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Daniel J Lyons, PHARM.D
• Ana Lilia Maldonado
• Cesar a Manrique
• Lisette V. Manriquez, NP
• Alline Goreti Marizcal Cota
• Nancy E Martinez, NMW
• Alaa Masjune, MD
• Jorge A Mata, MD
• Sergio Maury, MD
• Terrence McCarthy, RPH

• Emergency Medicine Physician in San Ysidro, CA
• Providers in San Ysidro, CA by specialty
• Emergency Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2019; 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.