Provider Demographics
NPI:1174598478
Name:DECHTER, MARK MICHAEL (MD)
Entity type:Individual
Prefix:DR
First Name:MARK
Middle Name:MICHAEL
Last Name:DECHTER
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Gender:M
Credentials:MD
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Mailing Address - Street 1:7301 MEDICAL CENTER DR
Mailing Address - Street 2:SUITE 500
Mailing Address - City:WEST HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91307-1904
Mailing Address - Country:US
Mailing Address - Phone:818-226-3666
Mailing Address - Fax:818-992-6853
Practice Address - Street 1:7301 MEDICAL CENTER DR
Practice Address - Street 2:SUITE 500
Practice Address - City:WEST HILLS
Practice Address - State:CA
Practice Address - Zip Code:91307-1904
Practice Address - Country:US
Practice Address - Phone:818-226-3666
Practice Address - Fax:818-992-6853
Is Sole Proprietor?:No
Enumeration Date:2006-02-21
Last Update Date:2013-02-26
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Provider Licenses
StateLicense IDTaxonomies
CAG31615207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
A44819Medicare UPIN