Mack, Scott William

Mack, Scott William is an individual health care provider with primary practice located at 1860 Mowry Ave Suite 400, Fremont CA 94538-1730. He recently has only one registered license in Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, which is considered as his primary health care specialty. Mack, Scott William can be contacted via phone (510) 796-7104.

Contact Information

Primary practice address
1860 Mowry Ave Suite 400 Fremont CA 94538-1730
Phone: (510) 796-7104
Fax: (510) 794-9783
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X G077240 California

Profile Details

NPI number 1003860073
LBN Legal business name Mack, Scott William
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 22nd, 2006
Last updated Jul 8th, 2007 - about 18 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 1003860073 NPPES
California MEDICAID 00G772401

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