Organization
ALBERT C MAK MD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ROSE MARIE RIVERA (ADMINISTRATOR)
(805) 577-8730
Entity
Organization
Contact information
Practice address
707 S GARFIELD AVE, BSMT, ALHAMBRA, CA 91801-5859
(805) 577-8730
(805) 991-4065
Mailing address
PO BOX 80520, SAN MARINO, CA 91118-8520
(805) 577-8730
(805) 991-4065
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
G79330
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G793300
—
CA
Enumeration date
10/26/2007
Last updated
03/24/2020
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