Mark Izquierdo-gallegos, is a medicare enrolled "Social Worker - Clinical" provider in Covina, California. His current practice location is
1359 N Grand Ave, Covina, California. You can reach out to his office (for appointments etc.) via phone at
(626) 430-2900.
Mark Izquierdo-gallegos is licensed to practice in California (license number 93163) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1659740520.
Healthcare Provider's Profile
| Full Name | Mark Izquierdo-gallegos |
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| Gender | Male |
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| Speciality | Social Worker - Clinical |
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| Location | 1359 N Grand Ave, Covina, California |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1659740520
- Provider Enumeration Date: 09/21/2015
- Last Update Date: 12/09/2019
Medicare PECOS Information:
- PECOS PAC ID: 0244655181
- Enrollment ID: I20200810000658
Medical Identifiers
Medical identifiers for Mark Izquierdo-gallegos such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1659740520 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 101YM0800X | Counselor - Mental Health | 71573 (California) | Secondary |
| 390200000X | Student In An Organized Health Care Education/training Program | (* (Not Available)) | Secondary |
| 1041C0700X | Social Worker - Clinical | 93163 (California) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Mark Izquierdo-gallegos allows following entities to bill medicare on his behalf.
| Entity Name | Los Angeles County Department Of Mental Health |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1083633929
PECOS PAC ID: 7416869896
Enrollment ID: O20031104000319 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mark Izquierdo-gallegos is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Mark Izquierdo-gallegos,
1359 N Grand Ave,
Covina, CA 91724-1016
Ph: (626) 430-2900 | Mark Izquierdo-gallegos,
1359 N Grand Ave,
Covina, CA 91724-1016
Ph: (626) 430-2900 |
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