Individual
LINDA MACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1425 S MAIN ST, WALNUT CREEK, CA 94596-5318
(925) 295-6210
Mailing address
2537 HOLLY VIEW CT, MARTINEZ, CA 94553-3457
Taxonomy
Speciality
Code
Description
License number
State
163WG0100X
Gastroenterology Registered Nurse
Primary
518853
CA
Other
Enumeration date
06/22/2007
Last updated
07/08/2007
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