Individual
DR. CLEVE S MACKENZIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
18582 MAIN ST, ATTN: HANA AYOUB, HUNTINGTON BEACH, CA 92648-1701
(714) 965-9696
(714) 965-9797
Mailing address
18582 MAIN ST, ATTN: HANA AYOUB, HUNTINGTON BEACH, CA 92648-1701
(714) 965-9696
(714) 965-9797
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
G68752
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G687520
—
CA
Enumeration date
08/31/2006
Last updated
06/06/2013
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