Individual
DR. ERNEST DANIEL MACKEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
13132 NEWPORT AVE, 100, TUSTIN, CA 92780-3429
(714) 565-7960
(714) 565-7982
Mailing address
13132 NEWPORT AVE, 100, TUSTIN, CA 92780-3429
(714) 565-7960
(714) 565-7982
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
A61274
CA
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
A61274
CA
Other
Enumeration date
03/17/2006
Last updated
01/04/2011
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