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

Mark Boonyasampant, MD

Individual provider Anatomic Pathology & Clinical Pathology Physician · NPI 1396037537

Mark Boonyasampant, MD is a Pathology in Fullerton, California. Graduated from New York Medical College in 2011, 15 years ago. Practices with The Pathology Group Inc, a 6-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
15
Trained at
New York Medical College
Licensed in
CA
In the registry since
2011
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

101 E Valencia Mesa Dr
Fullerton, CA 92835-3809
Phone: (510) 388-7271
Fax: (714) 446-7546
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Anatomic Pathology & Clinical Pathology Physician (primary) Taxonomy 207ZP0102X · Licence A126158 (CA)

Record details

NPI number1396037537
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorYes
NPI enumeratedMay 6, 2011
Last updated in NPPESJuly 21, 2022
Mailing address101 E Valencia Mesa Dr, Fullerton, CA 92835-3809

Medicare enrollment

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

Medicare specialtyPATHOLOGY
Medical schoolNEW YORK MEDICAL COLLEGE
Graduated 2011 (15 years in practice)
Group practice The Pathology Group Inc — 6 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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