Individual
DR. MACK ROACH III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1600 DIVISADERO STREET, H1031, SAN FRANCISCO, CA 94143-0001
(415) 353-7175
(415) 353-9883
Mailing address
1600 DIVISADERO STREET, H1031, SAN FRANCISCO, CA 94143-1708
(415) 353-7175
(415) 353-9883
Taxonomy
Speciality
Code
Description
License number
State
2085R0203X
Therapeutic Radiology Physician
Primary
00G42845
CA
Other
Enumeration date
06/08/2006
Last updated
07/08/2007
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