Basic Information
| Provider Information | |||||||||
| NPI: | 1730174806 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | RAYBECK | ||||||||
| FirstName: | MARK | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 909 SQUALICUM WAY | ||||||||
| Address2: | STE 102 | ||||||||
| City: | BELLINGHAM | ||||||||
| State: | WA | ||||||||
| PostalCode: | 982252077 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3606473377 | ||||||||
| FaxNumber: | 3607523214 | ||||||||
| Practice Location | |||||||||
| Address1: | 3444 KEARNY VILLA RD STE 100 | ||||||||
| Address2: | |||||||||
| City: | SAN DIEGO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 921231960 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8582683566 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/15/2005 | ||||||||
| LastUpdateDate: | 08/13/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | A74922 | CA | Y | Allopathic & Osteopathic Physicians | Anesthesiology |
No ID Information.