Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Mark S Fan, MD

Individual provider Obstetrics & Gynecology Physician · NPI 1164685632

Dr. Mark S Fan, MD is an Obstetrics/Gynecology in Bellevue, Washington. Qualified in 2006, 20 years ago. Practices with Northeast Valley Health Corporation, a 76-clinician group. Licensed in California, New York and Washington.

Years since qualifying
20
Licensed in
CA, NY, WA
In the registry since
2008
Specialties on file
3
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

1515 116th Ave NE Ste 205
Bellevue, WA 98004-3811
Phone: (310) 866-3707
Fax: (425) 999-4858
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Obstetrics & Gynecology Physician (primary) Taxonomy 207V00000X · Licence NOT YET (NY)
Obstetrics & Gynecology Physician Taxonomy 207V00000X · Licence MD60122545 (WA)
Obstetrics & Gynecology Physician Taxonomy 207V00000X · Licence A112478 (CA)

Record details

NPI number1164685632
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedJuly 5, 2008
Last updated in NPPESFebruary 3, 2021
Certification dateFebruary 3, 2021

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyOBSTETRICS/GYNECOLOGY
Medical schoolOTHER
Graduated 2006 (20 years in practice)
Group practice Northeast Valley Health Corporation — 76 clinicians
Accepts Medicare assignment Not indicated

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