Richard E Mack JR. M.D.

NPI 1023225810 - Surgery - 2086S0122X

NPI Details
NPI 1023225810
Gender Male
Enumeration Date 05/17/2007
Last Updated 07/08/2007
Entity Type Individual
Active Over 9 years ago
Practice Location
16311 VENTURA BLVD
SUITE 1080
ENCINO CA, 91436-2124, US
Phone (818) 501-5073
Fax
Business Location
16311 VENTURA BLVD
SUITE 1080
ENCINO CA, 91436-2124, US
Phone (818) 501-5073
Fax
Toxanomy
Taxonomy Code 2086S0122X
License State California
License Number G 81683
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According to our database, Dr. Richard E Mack JR. M.D. NPI is 1023225810, taxonomy code is 2086S0122X and license number is G 81683, license state is located at California. Richard E Mack JR. M.D. physically located at 16311 Ventura Blvd, Encino CA, 91436-2124. NPI Number Richard E Mack JR. M.D. has the Individual type.

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1023225810 NPI number is provided on an as is basis without warranty of any kind. 1023225810 is maintained by the National Plan & Provider Enumeration System. The contents of Richard E Mack JR. M.D. are for informational purposes only.