Mark S Wagner MD, a Medical Corporation

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

95003992 Issued in CA

Legal business name

MARK S WAGNER MD, A MEDICAL CORPORATION

Doing business as

OC Comprehensive Care

Practice address

515 Cabrillo Park Dr
Suite 120
Santa Ana, CA 92701-5016

Phone

(714) 558-8038

NPI assigned

Apr 7, 2016

Last updated

Jan 17, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Mark S Wagner, MDNPI 1700821709

Title

Ceo / President

Phone

(714) 558-8038

Specialties & licenses 1

Addresses

Other names 1

• OC Comprehensive Care Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Mark S Wagner, MD

  • General Practice Physician
  • Santa Ana, CA
  • NPI 1700821709
  Authorized official Same address or phone

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

{
    "created_epoch": "1459987200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1516147200000",
    "number": "1902260714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "261 W HOWARD ST",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911031529",
            "telephone_number": "310-218-3892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 CABRILLO PARK DR",
            "address_2": "SUITE 120",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927015016",
            "telephone_number": "714-558-8038"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK S WAGNER MD, A MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-07",
        "last_updated": "2018-01-17",
        "status": "A",
        "authorized_official_last_name": "WAGNER",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "CEO / PRESIDENT",
        "authorized_official_telephone_number": "714-558-8038",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "CA",
            "license": "95003992",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "OC Comprehensive Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Amber Nicole Marinoff, M.A.
• Mario G. Valdez D.D.S., Professional Corporation (Grand Family Dental Center)
• Cynthia Marie Mariuta, FNP-C
• Mark a. Goodfellow, D.D.S., Inc.
• Mark Girgis, D.M.D.
• Susan Deborah Mark
• Market Pharmacy LLC (Regions Pharmacy)
• Kristina Markovich
• Kiah Marks
• Michael Keli'I Marks

• Clinic/Center in Santa Ana, CA
• Providers in Santa Ana, CA by specialty
• Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2018; 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.