Individual
DR. R. SCOTT MACKIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
401 PARNASSUS AVE # LP220, SAN FRANCISCO, CA 94143-2211
(415) 476-7067
(415) 502-6364
Mailing address
1635 DIVISADERO ST, SUITE 625, BOX 1821, SAN FRANCISCO, CA 94143-0001
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
PSY20717
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00PSY207170
—
CA
Enumeration date
08/01/2006
Last updated
06/12/2008
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