Mark Steven Agness, M.D.
Individual provider Active NPI Family Medicine Physician · Marysville, CA
NPI 1609816743 · NPPES record last updated Aug 27, 2007
Key facts
- NPI
- 1609816743
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- G68116 (CA)
- Practice address
- 726 4TH Street
Marysville, CA 94901 - Phone
- (530) 749-4300
- NPI assigned
- Jun 7, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 4
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G68116 | CA | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Carilion Healthcare Corporation | Past | Accepting new patients | |
| Ridge Medical Group Inc. | Family Medicine | Past | Accepting new patients |
| Colusa Emergency Physicians Medical Group, Inc. | Past | Accepting new patients | |
| Carilion Healthcare Corporation | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | G68116 | CA | Yes |
Addresses
Primary practice location
726 4TH Street
Marysville, CA 94901
Mailing address
2100 Powell St
Ste 900
Emeryville, CA 94608-1826
Phone (510) 350-2600
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00G681160 | Medicaid | CA |
Other providers in Marysville, CA
- Adventist Health Physicians Network
- Adventist Health Physicians Network
- Aegis Treatment Centers, LLC
- Aegis Treatment Centers, LLC
- Kimberly-Ann Agcopra
- Duliamaria Aguilar
- Zainab Ajeena
- David Joseph Alessio
- Allen Alexander
- Hyo Sook Catherine Allen
All providers in Marysville, CA · Family Medicine Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 27, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.