Mack, Ida Phae

Mack, Ida Phae is an sole proprietor health care provider with primary practice located at 15317 Rayen St , North Hills CA 91343-5117. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Rehabilitation Practitioner, which is considered as her primary health care specialty. Mack, Ida Phae can be contacted via phone (818) 892-3423.

Contact Information

Primary practice address
15317 Rayen St North Hills CA 91343-5117
Phone: (818) 892-3423
Fax: (818) 893-4509
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Rehabilitation Practitioner 225400000X

Profile Details

NPI number 1184854788
LBN Legal business name Mack, Ida Phae
Credentials Bachelor of Arts (BA)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 17th, 2009
Last updated Jul 29th, 2009 - about 15 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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