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

Mark Ettore, MD

Individual provider Pediatric Anesthesiology Physician · NPI 1902250244

Mark Ettore, MD is an Anesthesiology in Philadelphia, Pennsylvania. Qualified in 2016, 10 years ago. Practices with Southern California Permanente Medical Group, an 11,242-clinician group and accepts Medicare assignment. Licensed in Pennsylvania.

Years since qualifying
10
Licensed in
PA
In the registry since
2016
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

3401 Civic Center Blvd
Philadelphia, PA 19104-4319
Phone: (215) 590-4557
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatric Anesthesiology Physician (primary) Taxonomy 207LP3000X · Licence MT210596 (PA)

Record details

NPI number1902250244
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedApril 22, 2016
Last updated in NPPESMay 7, 2024
Certification dateJune 5, 2020
Mailing address3870 Manor St, Philadelphia, PA 19128-5206

Medicare enrollment

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

Medicare specialtyANESTHESIOLOGY
Medical schoolOTHER
Graduated 2016 (10 years in practice)
Group practice Southern California Permanente Medical Group — 11242 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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