Individual
WILLIAM JACOB MACK IV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1520 SAN PABLO ST STE 3800, LOS ANGELES, CA 90033-5328
(323) 442-5720
Mailing address
PO BOX 31309, LOS ANGELES, CA 90031-0309
(323) 442-5720
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
A104088
CA
Other
Enumeration date
05/01/2008
Last updated
11/27/2023
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