Mark Charles De la Lama, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

3073 Issued in AZ

Practice address

4660 W Thomas Rd
Phoenix, AZ 85031-3718

Phone

(602) 442-4500

Fax

(602) 442-4505

NPI assigned

Jan 20, 2006

Last updated

Jul 8, 2007By the provider in NPPES

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)

Not enrolled

Credentials

Physician Assistant

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• PMM Healthcare

  • Primary Care Clinic/Center
  • Phoenix, AZ
  • NPI 1225275829
  NPD (past) Authorized official
• Plaza Medica Mexicana P.C

  • Health Service Clinic/Center
  • Phoenix, AZ
  • NPI 1376789768
  NPD (past)

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

{
    "created_epoch": "1137715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1801876214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6550 N 40TH DR",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850191206",
            "telephone_number": "623-322-5842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4660 W THOMAS RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850313718",
            "telephone_number": "602-442-4500",
            "fax_number": "602-442-4505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE LA LAMA",
        "first_name": "MARK",
        "middle_name": "CHARLES",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AZ",
            "license": "3073",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Esmeralda De la Cruz
• Miranda De la Cruz, LAC
• Stephanie De la Cruz
• Venessa B De la Cruz, L.C.S.W
• Anna De la Huerta
• Dwayne Paul De la Pena, LMSW
• Diana Belinda De la Rosa, LPC
• Humberto Enrique De la Torre Hogan
• Martha L De la Torre, LAC
• Rodrigo De la Torre

• Medical Physician Assistant in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Medical Physician Assistant in Arizona

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