MARK THOMAS DICKINSON (NPI# 1215914239) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215914239 |
| Entity Type | Individual |
| Full Name | MARK THOMAS DICKINSON |
| Credential | MD |
| Practice Address |
11370 Anderson Street Suite 1100 Loma Linda CA 92354 |
| Mailing Address |
11175 Campus Street Suite 11120 Loma Linda CA 92350 |
| Practice Telephone | 9095582830 |
| Practice Fax Number | 9095582602 |
| Mailing Telephone | 9095588292 |
| Mailing Fax Number | 6152509251 |
| Enumeration Date | 2005-12-30 |
| Last Update Date | 2015-12-16 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208800000X | Urology | A67587 | CA | Allopathic & Osteopathic Physicians |
| N | 208800000X | Urology | MD37792 | TN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | 64069941 | 05 | |
| TN | RR MEDICARE | P00035782 | 01 |
| TN | BLUE CROSS | 4067530 | 01 |
| TN | 3886483 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457430464 | Mark S Dickinson | Optometrist | 13190 Owens Way, Alpharetta, GA 30004-7357 | 2006-11-02 |
| 1124066055 | Mark David Dickinson | Dentist | 4 Scott Dyer Rd, Cape Elizabeth, ME 04107-2017 | 2006-06-03 |
| 1154320059 | Mark Wade Dickinson | Internal Medicine | 388 Commonwealth Ave, Mgh Back Bay, Boston, MA 02215-2800 | 2005-07-21 |
| Street Address |
11370 ANDERSON STREET SUITE 1100 |
| City | LOMA LINDA |
| State | CA |
| Zip Code | 92354 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902182421 | Sanaz Amini | Obstetrics & Gynecology | 11370 Anderson Street, Loma Linda, CA 92354 | 2011-10-28 |
| 1578732541 | Aya Eguchi | Internal Medicine | 11370 Anderson Street, Suite 3600, Loma Linda, CA 92354 | 2008-02-25 |
| 1831398700 | Junchan Joshua Yune | Obstetrics & Gynecology | 11370 Anderson Street, Suite 1100, Loma Linda, CA 92354 | 2007-07-12 |
| 1609898758 | Frances Patricia Batin | Specialist | 11370 Anderson Street, Suite 3600, Loma Linda, CA 92354 | 2006-07-24 |
| 1235189275 | Faculty Physicians and Surgeons of Llusm | Obstetrics & Gynecology | 11370 Anderson Street, Suite 3900, Loma Linda, CA 92354 | 2006-05-11 |
| 1417911710 | Joseph Louis Raffel | Urology | 11370 Anderson Street, Suite 2050, Loma Linda, CA 92354-3450 | 2006-04-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588264337 | Apple Red Nutrition Services | Dietitian, Registered | 357 W. 2nd St, Suite #2, Loma Linda, CA 92354 | 2020-10-30 |
| 1013517960 | Kristina Pulliam Markey | Nurse Practitioner | 11234 Anderson Strreet, Loma Linda, CA 92354 | 2020-10-29 |
| 1932725645 | Dev Priya Singhvi | Student in an Organized Health Care Education/Training Program | 11332 Mountain View Avenue, Westerly Building, Suite C, Gme Office, Loma Linda, CA 92354 | 2020-06-18 |
| 1750901278 | Angela N Torres | Student in an Organized Health Care Education/Training Program | Loma Linda University Health Emergency Medicine, 11234 Anderson Street, Loma Linda, CA 92354 | 2020-04-24 |
| 1548899230 | Holistic Physical Therapy Inc. | Physical Therapist | 25003 Starr Str, Loma Linda, CA 92354 | 2020-04-03 |
| 1508494071 | Eric Allen | Student in an Organized Health Care Education/Training Program | Loma Linda University Health Pediatrics, General, 11234 Anderson Street, Loma Linda, CA 92354 | 2020-03-31 |
| 1730640244 | Rose Valley Rcfe | Assisted Living Facility | 11574 Poplar St, Loma Linda, CA 92354 | 2019-03-27 |
| 1336633676 | David A Lawrence | Student in an Organized Health Care Education/Training Program | Loma Linda University Hospital, 11234 Anderson St., Loma Linda, CA 92354 | 2018-06-20 |
| 1205329547 | Rachael Nicole Spady | Student in an Organized Health Care Education/Training Program | Loma Linda University Health - Obstetrics & Gynecology, 11234 Anderson St, Loma Linda, CA 92354 | 2018-06-12 |
| 1447756069 | Anthony Ernest Sanchez | Otolaryngology | 11332 Mountain View, Westerly Building Suite C, Loma Linda, CA 92354 | 2018-04-03 |
| Find all providers in zip 92354 | ||||
| Taxonomy Code | 208800000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Urology |
| A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Urology, 2007. http://www.abu.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Urology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841515525 | Roger Li | Urology | 11234 Anderson Street, Gme Office Cp 21005, Loma Linda, CA 92354-2804 | 2010-04-06 |
| 1801023072 | Humberto Guadalupe Villarreal | Urology | 11234 Anderson St Rm A560, Loma Linda, CA 92354-2804 | 2009-06-16 |
| 1407941081 | David Stephen Benjamin | Urology | 11370 Anderson St Ste 1100, Loma Linda, CA 92354-3450 | 2006-10-03 |
| 1558997452 | Akin Soner Amasyali | Urology | 11234 Anderson St Rm A560, Loma Linda, CA 92354-2804 | 2020-03-23 |
| 1215458237 | Mohammad Hajiha | Urology | 11234 Anderson St Rm A560, Loma Linda, CA 92354-2804 | 2017-06-29 |
| 1871836437 | Milan Shah | Urology | 11370 Anderson St Ste 1100, Loma Linda, CA 92354 | 2013-04-02 |
| 1003073883 | Brian Hu | Urology | 11370 Anderson St Ste 1100, Loma Linda, CA 92354-3450 | 2008-05-20 |
| 1841468774 | Tekisha Urusha Lindler | Urology | 11234 Anderson St, Llumc Cp 21005, Loma Linda, CA 92354 | 2008-02-13 |
| 1093917106 | Lesli Izella Nicolay | Urology | 11370 Anderson St, Suite 2050, Loma Linda, CA 92354-3450 | 2007-06-01 |
| 1508073511 | Forrest C. Jellison | Urology | 11370 Anderson St Ste 1100, Loma Linda, CA 92354 | 2007-05-17 |
| Find all providers in LOMA LINDA | ||||
| City | LOMA LINDA |
| Zip Code | 92354 |
Please comment or provide details below to improve the information on MARK THOMAS DICKINSON.
| 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.