Individual provider · NPI-1

Dr. Mark Drake, D.P.M.

Podiatrist, Foot & Ankle Surgery · Roseville, CA

NPI number1184965725
StatusActive
Last updated in NPPESNov 6, 2014

Details

NPI
1184965725
Entity type
Individual (NPI-1)
Name
Dr. Mark Drake
Credential
D.P.M.
Sex
Male
Sole proprietor
No
Enumeration date
Mar 6, 2013
Last updated
Nov 6, 2014

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
213ES0103X Podiatrist, Foot & Ankle SurgeryT09-2012TXYes

Practice location

5 Medical Plaza Dr
110
Roseville, CA 95661-2865

Phone 916-782-3444 · Fax 916-782-3490

Mailing address

3800 J St
200
Sacramento, CA 95816-5551

Phone 916-453-8900 · Fax 916-454-4359

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.

Other Podiatrist, Foot & Ankle Surgery providers in Roseville, CA