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Contact Information

MARK R HOMICZ, MD
1701 4TH ST STE 120
SANTA ROSA, CA95404-3661
 Phone: 707-523-7025
 Fax: 707-523-3024
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Otolaryngology

207Y00000X 04 Physician/Otolaryngology
 

Plastic Surgery within the Head & Neck

207YX0007X 04 Physician/Otolaryngology
Indicates primary specialty

NPI Profile & details for MARK R HOMICZ · (Male)

NPI # 1336198449
Status Active
Credentials MD
Entity Individual
Enumeration date 05/08/2006
Last updated 02/07/2012 - About 14 years ago
Sole proprietor 1 No
Identifiers
  • CA License # A70413
  • CA Other 00A704130 BLUE SHIELD OF CALIFORNIA
  • CA Other P00933198 RAILROAD MEDICARE
Hospital affiliation(s)
  • CALIFORNIA PACIFIC MEDICAL CTR-DAVIES CAMPUS HOSP - (Acute Care)
    601 DUBOCE AVE
    SAN FRANCISCO, CA 94117
  • SANTA ROSA MEMORIAL HOSPITAL - (Acute Care)
    1165 MONTGOMERY DR
    SANTA ROSA, CA 95405
  • SUTTER MEDICAL CENTER OF SANTA ROSA - (Acute Care)
    3325 CHANATE RD
    SANTA ROSA, CA 95404
  • UKIAH VALLEY MEDICAL CENTER/HOSPITAL D - (Acute Care)
    275 HOSPITAL DRIVE
    UKIAH, CA 95482
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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