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GREGORY R. MACK MD INC NPI 1962589234


NPI Information

NPI: 1962589234
Provider Name: GREGORY R. MACK MD, INC
Classification: Orthopaedic Surgery - 207X00000X
Entity Type: Organization
Address:
8008 FROST ST
SUITE 403
SAN DIEGO, CA
ZIP 92123
Phone: (858) 715-9200
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GREGORY R. MACK MD, INC is an orthopaedic surgery in San Diego, CA. The provider is an orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system. GREGORY R. MACK MD, INC NPI is 1962589234. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

8008 FROST ST
SUITE 403
SAN DIEGO, CA
ZIP 92123-205
Phone: (858) 715-9200
Fax: (858) 715-1230

The provider's authorized official is Gregory Robert Mack .
The authorized official title is Owner and has the following contact phone number (858) 715-9200.

The enumeration date for this NPI number is 11/1/2006 and was last updated on 9/22/2017.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207X00000XOrthopaedic SurgeryG37547CALIFORNIAYes
22086S0105XSurgerySurgery of the HandG37547CALIFORNIANo

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
100G375470MEDICAIDCALIFORNIA
2G37547MEDICARE ID-TYPE UNSPECIFIEDCALIFORNIA
3W19719OTHERCALIFORNIAMEDICARE PTAN
44890140001MEDICARE NSCCALIFORNIA
5A91902MEDICARE UPINCALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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