MARK CROSS PA-C NPI 1205964939

NPI Information

NPI: 1205964939
Provider Name: MARK CROSS, PA-C
Classification: Physician Assistant - 363AM0700X
Entity Type: Individual

Specialization: Medical

PECOS Registration: Yes

Address:
4723 W MAIN ST STE H
GUADALUPE, CA
ZIP 93434
Phone: (805) 361-8017
Get Directions

Mark Cross, PA-C is a medical physician assistant in Guadalupe, CA. Mark Cross, PA-C NPI is 1205964939. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

4723 W MAIN ST STE H
GUADALUPE, CA
ZIP 93434-787
Phone: (805) 361-8017
Fax: (805) 361-8097

The NPI 1205964939 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 3/2/2007 and was last updated on 3/3/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363AM0700X	Physician Assistant	Medical	2322	COLORADO	No
2	363AM0700X	Physician Assistant	Medical	19505	CALIFORNIA	Yes
3	2084P0800X	Psychiatry & Neurology	Psychiatry	19505	CALIFORNIA	No

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	83821368	MEDICAID	CALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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