Dr Mark Jeffrey Mogul, MD | |
2550 Sister Mary Columba Dr, Red Bluff, CA 96080-4327 | |
(813) 295-1505 | |
Not Available |
Full Name | Dr Mark Jeffrey Mogul |
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Gender | Male |
Speciality | Pediatrics |
Location | 2550 Sister Mary Columba Dr, Red Bluff, California |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1336113752 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2080P0207X | Pediatrics - Pediatric Hematology-oncology | ME121139 (Florida) | Secondary |
208000000X | Pediatrics | G068539 (California) | Primary |
Entity Name | Orlando Health Medical Group Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1669429577 PECOS PAC ID: 9537059084 Enrollment ID: O20040318000044 |
Mailing Address | Practice Location Address |
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Dr Mark Jeffrey Mogul, MD 11913 Keating Dr, Tampa, FL 33626-2531 Ph: (813) 295-5105 | Dr Mark Jeffrey Mogul, MD 2550 Sister Mary Columba Dr, Red Bluff, CA 96080-4327 Ph: (813) 295-1505 |
Kisung Kim, BM Pediatrics Medicare: Medicare Enrolled Practice Location: 2450 Sister Mary Columba Dr, Red Bluff, CA 96080 Phone: 530-527-0414 Fax: 530-527-3720 | |
Kimberli Frantz, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 2450 Sister Mary Columba Dr, Red Bluff, CA 96080 Phone: 530-527-0414 | |
Dr. Danielle Dionne Dixon, D.O., M.P.H. Pediatrics Medicare: Medicare Enrolled Practice Location: 2450 Sister Mary Columba Dr, Red Bluff, CA 96080 Phone: 530-527-0414 | |
Dr. Lena Renee Schultz, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 2450 Sister Mary Columba Dr, Red Bluff, CA 96080 Phone: 530-527-0414 Fax: 530-528-4423 | |
Maria Nelisa N Tan, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 2450 Sister Mary Columba Dr, Red Bluff, CA 96080 Phone: 530-527-0414 Fax: 530-528-4423 | |
Annette Ndagano, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 2450 Sister Mary Columba Dr, Red Bluff, CA 96080 Phone: 530-527-0414 Fax: 530-528-4423 |