Individual
DAVID MACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1045 9TH AVE, SAN DIEGO, CA 92101-5504
(619) 235-2600
Mailing address
1045 9TH AVE, SAN DIEGO, CA 92101-5504
(619) 235-2600
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
689068
CA
Other
Enumeration date
08/18/2017
Last updated
07/21/2022
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