Mack, Gregory R

Mack, Gregory R is an sole proprietor health care provider with primary practice located at 8008 Frost St Suite 403, San Diego CA 92123-4205. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery of the Hand, which is considered as his primary health care specialty. Mack, Gregory R can be contacted via phone (858) 715-9200.

Contact Information

Primary practice address
8008 Frost St Suite 403 San Diego CA 92123-4205
Fax: (858) 715-1230
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery of the Hand 2086S0105X G37547 California

Profile Details

NPI number 1528169513
LBN Legal business name Mack, Gregory R
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 25th, 2006
Last updated Aug 6th, 2013 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1528169513 NPPES
Other W19719 MEDICARE PTAN
MEDICAID 00G375470 MEDICARE PTAN

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