DOUGLAS K. MACK (NPI# 1124195045) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124195045 |
| Entity Type | Individual |
| Full Name | DOUGLAS K. MACK |
| Credential | MD |
| Practice Address |
9961 Sierra Ave Fontana CA 92335-6720 |
| Practice Telephone | 9094273910 |
| Mailing Telephone | 9094273910 |
| Enumeration Date | 2006-11-29 |
| Last Update Date | 2008-09-23 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208100000X | Physical Medicine & Rehabilitation | A65889 | CA | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861993552 | Douglas Timothy Mack | General Practice | 3551 Roger Brooke Dr, Jbsa Ft Sam Houston, TX 78234-4504 | 2018-02-27 |
| Street Address |
9961 SIERRA AVE |
| City | FONTANA |
| State | CA |
| Zip Code | 92335-6720 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578560199 | Barbara Ann Mahoney | Nurse Practitioner | 9961 Sierra Ave, Fontana, CA 92335-6720 | 2005-06-29 |
| 1023629979 | Whitney Mah | Speech-Language Pathologist | 9961 Sierra Ave, Fontana, CA 92335-6720 | 2020-08-13 |
| 1083224166 | Jennifer Hull | Genetic Counselor, MS | 9961 Sierra Ave, Fontana, CA 92335-6720 | 2020-08-04 |
| 1568081842 | Jorge Kareem Sierra | Radiologic Technologist | 9961 Sierra Ave, Fontana, CA 92335-6720 | 2020-04-16 |
| 1821625963 | Syed Sajjad Sarwar Naqvi | Student in an Organized Health Care Education/Training Program | 9961 Sierra Ave, Fontana, CA 92335-6720 | 2020-03-26 |
| 1730716903 | Hannah Choi | Student in an Organized Health Care Education/Training Program | 9961 Sierra Ave, Fontana, CA 92335-6720 | 2020-03-26 |
| 1912534413 | Mia Raquel Montoya | Student in an Organized Health Care Education/Training Program | 9961 Sierra Ave, Fontana, CA 92335-6720 | 2020-03-25 |
| 1093342461 | Jennica Kahkejian | Student in an Organized Health Care Education/Training Program | 9961 Sierra Ave, Fontana, CA 92335-6720 | 2020-03-25 |
| 1881221299 | Youstina Youssef | Student in an Organized Health Care Education/Training Program | 9961 Sierra Ave, Fontana, CA 92335-6720 | 2020-03-25 |
| 1790312015 | Sara Tong | Student in an Organized Health Care Education/Training Program | 9961 Sierra Ave, Fontana, CA 92335-6720 | 2020-03-25 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104425131 | Hossein Malakooti A Dental Corporation | Clinic/Center | 16540 Merrill Ave, Fontana, CA 92335 | 2020-10-21 |
| 1790312791 | Trevor Nguyen | Student in an Organized Health Care Education/Training Program | 17234 Valley Blvd, Building A, Fontana, CA 92335 | 2020-03-27 |
| 1184251365 | Benjamin Chang | Student in an Organized Health Care Education/Training Program | 17234 Valley Blvd., Bldg. A, Fontana, CA 92335 | 2020-03-26 |
| 1407487309 | Perla Hernandez | Licensed Vocational Nurse | 14677 Merrill Aver, Fontana, CA 92335 | 2020-01-29 |
| 1013552660 | Valencia Malone | Licensed Vocational Nurse | 14677 Merrill, Fontana, CA 92335 | 2019-11-07 |
| 1831749779 | Daniel Eric Wright | Student in an Organized Health Care Education/Training Program | 14677 Merrell Ave., Fontana, CA 92335 | 2019-09-12 |
| 1962069815 | Melissa Rivera | Licensed Vocational Nurse | 15217 San Bernardino Ave., Fontana, CA 92335 | 2019-05-28 |
| 1275199770 | Jennifer Lynn Malone | Peer Specialist | 14677 Merrall Ave, Fontana, CA 92335 | 2019-05-10 |
| 1770147894 | Noelle Chong | Registered Nurse | 14677 Merill Ave, Fontana, CA 92335 | 2019-04-24 |
| 1992261929 | Destiny Alzate | Counselor | 1467 Merrill Ave, Fontana, CA 92335 | 2019-02-14 |
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| Taxonomy Code | 208100000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Physical Medicine & Rehabilitation |
| Physical medicine and rehabilitation, also referred to as rehabilitation medicine, is the medical specialty concerned with diagnosing, evaluating, and treating patients with physical disabilities. These disabilities may arise from conditions affecting the musculoskeletal system such as neck and back pain, sports injuries, or other painful conditions affecting the limbs, such as carpal tunnel syndrome. Alternatively, the disabilities may result from neurological trauma or disease such as spinal cord injury, head injury or stroke. A physician certified in physical medicine and rehabilitation is often called a physiatrist. The primary goal of the physiatrist is to achieve maximal restoration of physical, psychological, social and vocational function through comprehensive rehabilitation. Pain management is often an important part of the role of the physiatrist. For diagnosis and evaluation, a physiatrist may include the techniques of electromyography to supplement the standard history, physical, x-ray and laboratory examinations. The physiatrist has expertise in the appropriate use of therapeutic exercise, prosthetics (artificial limbs), orthotics and mechanical and electrical devices. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Physical Medicine and Rehabilitation, 2007. http://www.abpmr.org/. American Osteopathic Board of Physical Medicine and Rehabilitation, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Physical Medicine and Rehabilitation. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Physical Medicine and Rehabilitation. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760897995 | Krista Stanton-mouttaki | Physical Medicine & Rehabilitation | 9961 Sierra Ave, Fontana, CA 92335-6720 | 2014-06-26 |
| 1710253430 | Mustafa Khan | Physical Medicine & Rehabilitation | 9961 Sierra Ave, Fontana, CA 92335-6720 | 2012-03-27 |
| 1851681464 | Tina Wang | Physical Medicine & Rehabilitation | 9985 Sierra Ave, Mob 2, 1st Floor, Fontana, CA 92335-6720 | 2011-04-15 |
| 1306032537 | Christine Torralba Diaz | Physical Medicine & Rehabilitation | 9961 Sierra Ave, Kaiser Permanente Department of Pm&r, Fontana, CA 92335-6720 | 2007-09-21 |
| 1689881039 | Chakradhar Penta | Physical Medicine & Rehabilitation | 9961 Sierra Ave, Mob 2 - Physical Medicine, Fontana, CA 92335-6720 | 2007-05-16 |
| 1396884094 | Gerald R. Goodlow | Physical Medicine & Rehabilitation | 9961 Sierra Ave, Fontana, CA 92335-6720 | 2007-02-06 |
| 1285773986 | Adrianne C. Beck | Physical Medicine & Rehabilitation | 9961 Sierra Ave, Fontana, CA 92335-6720 | 2007-02-06 |
| 1689723900 | Herbert Lee | Physical Medicine & Rehabilitation | 9961 Sierra Ave, Fontana, CA 92335-6720 | 2007-01-09 |
| 1346398336 | John Luen Shen | Physical Medicine & Rehabilitation | 9961 Sierra Ave, Fontana, CA 92335-6720 | 2007-01-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477154730 | Drew Matthew Lemay | Physical Medicine & Rehabilitation | 2501 S El Camino Real, San Clemente, CA 92672-3350 | 2020-11-03 |
| 1821698325 | Karen Pena | Physical Medicine & Rehabilitation | 930 S Mount Vernon Ave, Grand Terrace, CA 92324-3928 | 2020-10-26 |
| 1104423052 | Prehab LLC | Physical Medicine & Rehabilitation | 10405 Sd Mssn Rd Ste 103105, San Diego, CA 92108-2102 | 2020-10-05 |
| 1699381517 | Paige Lauren Stephens | Physical Medicine & Rehabilitation | 6961 Los Amigos Cir, Huntington Beach, CA 92647-6659 | 2020-09-16 |
| 1740895788 | Rebecca Niamtu | Physical Medicine & Rehabilitation | 364 S Cloverdale Ave, Los Angeles, CA 90036-3478 | 2020-09-15 |
| 1245845296 | Brianna Brooskin | Physical Medicine & Rehabilitation | 2850 Adrian St Apt 102, San Diego, CA 92110-5700 | 2020-09-15 |
| 1366057622 | Jaime Lyn Kelley | Physical Medicine & Rehabilitation | 10213 Tillicum Way, Nevada City, CA 95959-2019 | 2020-09-14 |
| 1346853868 | Edwin Castillo | Physical Medicine & Rehabilitation | 767 Freeman Ave Apt 3, Long Beach, CA 90804-4988 | 2020-08-25 |
| 1225640675 | Hema Kamal | Physical Medicine & Rehabilitation | 1049 El Monte Ave, Mountain View, CA 94040-2398 | 2020-08-18 |
| 1760094338 | Bayhealth Connect LLC | Physical Medicine & Rehabilitation | 30 Union Ave Ste 210, Campbell, CA 95008-3162 | 2020-08-17 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.