Mark Antonio Bardalez

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

License

MPSS-CQILDB Issued in CA

Practice address

307 S Central Ave
Los Angeles, CA 90013-1709

Phone

(213) 372-5233

NPI assigned

Jan 5, 2024

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1704412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763942400000",
    "number": "1477323970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12070 TELEGRAPH RD",
            "city": "SANTA FE SPRINGS",
            "state": "CA",
            "postal_code": "906703771",
            "telephone_number": "562-777-7500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "307 S CENTRAL AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900131709",
            "telephone_number": "213-372-5233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARDALEZ",
        "first_name": "MARK",
        "middle_name": "ANTONIO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-01-05",
        "last_updated": "2025-11-24",
        "certification_date": "2025-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "CA",
            "license": "MPSS-CQILDB",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sue Barco
• Nazanine Barcohana, D.D.S.
• Jennifer Lynn Barczykowski
• Jeremy Scott Bard, LPT
• Boo Young Jun Bardales, DNP, AGPCNP-BC, C
• Christian Bardan, MD
• James Migliaccio Bardes, M.D.
• Michael Anthony Bardo, PA-C
• Denise Bardovi, MA, MFT
• Richard Bardowell, M.D.

• Peer Specialist in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Peer Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2025; 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.