Most Relevant Information
Provider Data
| NPI Number: | 1003812744 |
| Provider Name: | MARK GREGORY ELLIS MD |
| Entity Type: | Individual |
| Taxonomy Code: | 208000000X |
| Specialty: | Pediatrics |
| License Number: | G65432 |
Most Important Dates
| Enumeration Date: | 06/27/2005 |
| Last Updated: | 03/17/2018 |
Provider Practice Location
2200 TYDD ST
EUREKA
CA
955011284
Practice Location Phone/Fax
| Phone: | 7072697051 |
| Fax: | 7072697054 |
Provider Mailing Location
670 9TH ST STE 203
ARCATA
CA
955216249
Provider Mailing Phone/Fax
| Phone: | 7078268633 |
| Fax: | 7078268638 |
Suggested EMR
Pediatrics EMR