DR. ROBERT THOMAS MACK (NPI# 1356985105) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356985105 |
| Entity Type | Individual |
| Full Name | DR. ROBERT THOMAS MACK |
| Credential | MD |
| Practice Address |
1311 Westview Dr Berkeley CA 94705-1652 |
| Practice Telephone | 5109679378 |
| Mailing Telephone | 5109679378 |
| Enumeration Date | 2019-11-05 |
| Last Update Date | 2019-11-05 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208D00000X | General Practice | G25338 | CA | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619018793 | Robert Gary Mack II | Contractor | 2712 Edgewater Drive, Greenwood, AR 72936 | 2007-02-09 |
| 1932107778 | Robert J S Mack | Optometrist | 1220 W Higgins Rd, Ste 102, Hoffman Estates, IL 60169-4033 | 2005-07-13 |
| 1811449861 | Robert Mckensey Mack | Social Worker | 333 S Beaudry Ave, Los Angeles, CA 90017-1466 | 2016-10-25 |
| 1245465970 | Robert D Mack | Dentist | 1324 23rd St S, Fargo, ND 58103-3702 | 2009-05-26 |
| 1093820615 | Robert Henry Mack | Dentist | 10 Washington St, Bloomfield, NJ 07003-3412 | 2006-08-21 |
| 1366406407 | Robert P Mack | Orthopaedic Surgery | 39000 Bob Hope Dr, Harry & Diane Rinker Building, Rancho Mirage, CA 92270-3221 | 2006-04-14 |
| 1588665129 | Robert Mack | Radiology | 5508 Summerhill Rd, Texarkana, TX 75503-1822 | 2005-08-04 |
| Street Address |
1311 WESTVIEW DR |
| City | BERKELEY |
| State | CA |
| Zip Code | 94705-1652 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447882956 | Diane Lomas Wyatt | Marriage & Family Therapist | 2340 Ward St. Ste 104, Berkeley, CA 94705 | 2020-02-12 |
| 1700371275 | Icecreamwala Dermatology Inc | Dermatology | 2435 Webster St Ste 101, Berkeley, CA 94705 | 2018-06-27 |
| 1396253803 | David R Shaddock | Marriage & Family Therapist | 3030 Ashby Avenue, # 105, Berkeley, CA 94705 | 2018-01-18 |
| 1821504432 | Allegra Tringali | Physical Therapist | 2450 Ashby Ave Fl 6, Berkeley, CA 94705 | 2017-12-19 |
| 1659898740 | Hunter Brown | Student in an Organized Health Care Education/Training Program | Wright Institute Clinical Services 1918 University Ave, Suite 2b, Berkeley, CA 94705 | 2017-08-29 |
| 1588014534 | Heather Valdez | Social Worker | 2185 Ashby Ave, Berkeley, CA 94705 | 2016-06-20 |
| 1215350145 | S.e.e.d.s. (social and Emotional Education Development and Support) | Community/Behavioral Health | 3120 Telegraph Avenue Ste 9, Berkeley, CA 94705 | 2014-01-29 |
| 1144580960 | Benjamin Tucker | Counselor | 2625 Alcatraz Ave Ste 609, Berkeley, CA 94705 | 2012-05-26 |
| 1881966141 | Jennifer Cowherd | Behavioral Analyst | 2201 Woolsey St, Berkeley, CA 94705 | 2012-02-02 |
| 1518255892 | Erika D Huguenard | Counselor | 2811a College Avenue, Berkeley, CA 94705 | 2011-07-20 |
| Find all providers in zip 94705 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316357478 | Jonathan Francis | General Practice | 1064 Keeler Ave, Berkeley, CA 94708-1752 | 2014-04-29 |
| 1336491984 | Stephanie Maria Daniel | General Practice | 1700 Shattuck Ave, Berkeley, CA 94709-3402 | 2012-10-05 |
| 1447519707 | Jennifer Elizabeth Stockford | General Practice | Uhs Tang Center Uc Berkeley:2222 Bancroft Way, #4300, Berkeley, CA 94720-4300 | 2012-05-08 |
| 1245518224 | Thomas K. Stern, M.d. P.C. | General Practice | 3000 Colby St Ste 110, Berkeley, CA 94705-2090 | 2011-07-25 |
| 1326244765 | Gabriella Kellerman | General Practice | 984 Oxford St, Berkeley, CA 94707-2435 | 2007-06-22 |
| 1467443192 | Alia Annette Najjar | General Practice | 1737 Solano Ave Apt 110, Berkeley, CA 94707-2210 | 2005-11-02 |
| 1518109248 | Dawn Brown | General Practice | 1524 Fairview St, Berkeley, CA 94703-2318 | 2009-03-26 |
| 1861610578 | Melissa Kay Arciaga | General Practice | 2510 Webster St, Berkeley, CA 94705-2504 | 2007-04-20 |
| 1073626768 | Stephen Edward Langer | General Practice | 3031 Telegraph Ave, Berkeley, CA 94705-2051 | 2006-08-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851992986 | Lindsay Fry | General Practice | 375 Bonair St Apt 1, La Jolla, CA 92037-5911 | 2020-11-04 |
| 1255939674 | Kiira Health Practice Ca PC | General Practice | 123 S Figueroa St Apt 1202, Los Angeles, CA 90012-5490 | 2020-10-16 |
| 1851999627 | Golden State Medical Center PC | General Practice | 2551 San Ramon Valley Blvd Ste 108, San Ramon, CA 94583-1661 | 2020-10-14 |
| 1598362709 | Afua Takyi | General Practice | 1555 River Park Dr Ste 211, Sacramento, CA 95815-4604 | 2020-10-01 |
| 1316553530 | Kimberly Ann Callaway | General Practice | 4893 Drakewood Ter, San Diego, CA 92130-1406 | 2020-09-22 |
| 1376156109 | Gtl Medical Group Inc | General Practice | 14555 Hamlin St Ste 107, Van Nuys, CA 91411-1617 | 2020-08-31 |
| 1922611896 | Daniel Lynn Johnson | General Practice | 74075 El Paseo Ste B2, Palm Desert, CA 92260-4118 | 2020-08-28 |
| 1235755299 | Hofmeister Medical, PC | General Practice | 31735 Riverside Dr Ste K, Lake Elsinore, CA 92530-7816 | 2020-06-24 |
| 1033733779 | South Bay Regenerative Medical Spa Inc | General Practice | 412 S Pacific Coast Hwy Ste 100, Redondo Beach, CA 90277-3712 | 2020-05-28 |
| 1568085041 | Integrated Advanced Medicine Inc | General Practice | 210 S Grand Ave Ste 408, Glendora, CA 91741-4282 | 2020-05-19 |
| Find all providers with the same taxonomy | ||||
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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.