Mark E Eastham M D a Professional Corporation

Primary specialty

Neurological Surgery PhysicianTaxonomy code 207T00000X

License

G65379 Issued in CA

Legal business name

MARK E EASTHAM M D A PROFESSIONAL CORPORATION

Practice address

250 Bon Air Rd
Greenbrae, CA 94904-1702

Phone

(415) 925-7220

NPI assigned

Jul 2, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Mark Edward Eastham, M.D.

Title

Medical Director

Phone

(408) 315-1814

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1246492800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1247788800000",
    "number": "1821227562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2505 SAMARITAN DR STE 508",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951244014",
            "telephone_number": "408-315-1814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 BON AIR RD",
            "city": "GREENBRAE",
            "state": "CA",
            "postal_code": "949041702",
            "telephone_number": "415-925-7220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK E EASTHAM M D A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-02",
        "last_updated": "2009-07-17",
        "status": "A",
        "authorized_official_last_name": "EASTHAM",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "EDWARD",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "408-315-1814",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Neurological Surgery",
            "state": "CA",
            "license": "G65379",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Neurological Surgery Physician in Greenbrae, CA
• Providers in Greenbrae, CA by specialty
• Neurological Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2009; 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.