DR. MARK S FAN (NPI# 1164685632) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164685632 |
| Entity Type | Individual |
| Full Name | DR. MARK S FAN |
| Credential | MD |
| Practice Address |
1515 116th Ave Ne Ste 205 Bellevue WA 98004-3811 |
| Mailing Address |
Po Box 741 Mercer Island WA 98040-0741 |
| Practice Telephone | 3108663707 |
| Practice Fax Number | 4259994858 |
| Mailing Fax Number | 4259994858 |
| Enumeration Date | 2008-07-05 |
| Last Update Date | 2011-04-12 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207V00000X | Obstetrics & Gynecology | MD60122545 | WA | Allopathic & Osteopathic Physicians |
| Y | 207V00000X | Obstetrics & Gynecology | NOT YET | NY | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | STATE L&I | 0264461 | 01 |
| Street Address |
1515 116TH AVE NE STE 205 |
| City | BELLEVUE |
| State | WA |
| Zip Code | 98004-3811 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285036228 | Olga Abramova | Nurse Practitioner | 1515 116th Ave Ne Ste 205, Bellevue, WA 98004-3811 | 2014-09-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306458328 | Geneva Paula Hoskins-dorsey | Nurse Practitioner | 11120 Ne 33rd Place, Suite 202, Bellevue, WA 98004 | 2020-08-20 |
| 1720553613 | Christine Eyler | Pediatrics | Bellevue Pediatrics, C & C Medical Associates, 1940 116th Ave Ne, Ste 200, Bellevue, WA 98004 | 2018-10-08 |
| 1437634730 | Hazelden Betty Ford Foundation | Clinic/Center | 1231 116th Ave. Ne Suite 410, Bellevue, WA 98004 | 2018-10-02 |
| 1356827828 | Seattle Spine Group, Pllc | Orthopaedic Surgery | 1220 116th Ave Ne Ste 102, Bellevue, WA 98004 | 2018-07-17 |
| 1669989216 | Atsuko Nakajima | Acupuncturist | 2223 112th Ave. Ne, Ste 201, Bellevue, WA 98004 | 2018-01-04 |
| 1740794718 | Radka Chapin Counseling, LLC | Clinic/Center | 1611 116th Ave Ne Ste 119, Bellevue, WA 98004 | 2017-11-28 |
| 1962912105 | Cuyler Ann Simmons | Counselor | 3805 108th Ave Ne Ste 204, Bellevue, WA 98004 | 2017-10-02 |
| 1639690357 | Nicolas Lopez-montalvo | Behavioral Analyst | 3003 Northup Way Suite 200, Bellevue, WA 98004 | 2017-07-03 |
| 1124579537 | Matthew Thomas Haley | Pharmacist | 107 Bellevue Way, Se, Bellevue, WA 98004 | 2016-10-20 |
| 1649727348 | Kelsey Tanaka | Nurse Practitioner | 400- 108th Ave Ne, Suite 100, Bellevue, WA 98004 | 2016-09-10 |
| Find all providers in zip 98004 | ||||
| Taxonomy Code | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831659275 | Mary L Chandler | Obstetrics & Gynecology | 6510 151st Pl Se, Bellevue, WA 98006-5026 | 2019-03-21 |
| 1003184839 | Jill Rosetta Varni | Obstetrics & Gynecology | 9923 Lake Washington Blvd Ne, Bellevue, WA 98004-6068 | 2011-12-07 |
| 1891945010 | Glen P Hung | Obstetrics & Gynecology | 68 Cascade Key, Bellevue, WA 98006-1030 | 2008-09-24 |
| 1720240567 | Janice Lavoie Dobson | Obstetrics & Gynecology | 3865 112th Ave Ne, Bellevue, WA 98004-7657 | 2008-07-01 |
| 1093731135 | Katharine Barrett Avendano | Obstetrics & Gynecology | 2625 Northup Way, Bellevue, WA 98004-1431 | 2006-07-14 |
| 1245274802 | Bellevue Obstetrics and Gynecology Associates PC | Obstetrics & Gynecology | 11507 S 42nd St, Suite 109, Bellevue, NE 68123-6122 | 2006-06-15 |
| 1811996531 | Ann M Kolwitz | Obstetrics & Gynecology | 1231 116th Ave Ne, Suite 950, Bellevue, WA 98004-3804 | 2005-07-14 |
| 1619379039 | Unified Women's Healthcare of Washington Pllc | Obstetrics & Gynecology | 800 Bellevue Way Ne, Suite 400, Bellevue, WA 98004-4286 | 2014-09-17 |
| 1770901357 | Alyson Diana Guillet | Obstetrics & Gynecology | 1231 116th Ave Ne Ste 950, Bellevue, WA 98004-3832 | 2014-04-01 |
| 1467873885 | Natalia Dvorak, Md, Pllc | Obstetrics & Gynecology | 1600 116th Ave Ne, Suite 104, Bellevue, WA 98004-3014 | 2014-01-03 |
| Find all providers in BELLEVUE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.