Elisabeth Ann Mack (NPI# 1780270900) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider Identifier (NPI) | 1780270900 |
| Entity Type | Individual |
| Full Name | Elisabeth Ann Mack |
| Credential | RN |
| Gender | Female |
| Practice Address |
4130 Maryland St San Diego CA 92103-2330 |
| Practice Telephone | 6193703049 |
| Mailing Address |
4130 Maryland St San Diego CA 92103-2330 |
| Mailing Telephone | 6193703049 |
| Sole Proprietor | Yes, this individual is a Sole Proprietor |
| Enumeration Date | 2020-12-13 |
| Last Update Date | 2020-12-13 |
| Primary | Taxonomy | Classification | Taxonomy Group | License Number | State |
|---|---|---|---|---|---|
| Yes | 163WG0000X | Registered Nurse · General Practice | Nursing Service Providers | RN452901 | CA |
| Taxonomy Code | 163WG0000X |
| Grouping | Nursing Service Providers |
| Classification | Registered Nurse |
| Specialization | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346846219 | Maigan Wright | Registered Nurse | 4011 Ashford St, San Diego, CA 92111-3501 | 2020-12-07 |
| 1255987848 | Leila Alexandra Perry | Registered Nurse | 1501 Island Ave Apt 437, San Diego, CA 92101-7965 | 2019-08-10 |
| 1033604475 | Jila Ghabeljoo | Registered Nurse | 12672 Carmel Country Rd Unit 49, San Diego, CA 92130-3180 | 2018-06-28 |
| 1124545645 | Temitayo Olagbemi | Registered Nurse | 446 Alta Rd # 5300, San Diego, CA 92158-3018 | 2017-08-25 |
| 1376522193 | Anna Gruetzmacher | Registered Nurse | 34101 Farenholt Ave, Nshs-sd Idc, San Diego, CA 92134-7000 | 2006-01-11 |
| 1962018465 | Erik Mantsch | Registered Nurse | 3851 Rosecrans St, San Diego, CA 92110-3115 | 2020-09-20 |
| 1003422080 | Michelle Renee Zittlau-johnson | Registered Nurse | 1260 Morena Blvd Ste 100, San Diego, CA 92110-3850 | 2020-09-16 |
| 1215545496 | Priscilla Adams Hunter | Registered Nurse | 3851 Rosecrans St, San Diego, CA 92110-3115 | 2020-07-14 |
| 1497379812 | Valentine Daniele Aljabi | Registered Nurse | 6991 Balboa Ave, San Diego, CA 92111-3447 | 2020-06-01 |
| 1609427814 | Joan Balahadia | Registered Nurse | 4276 54th Pl Ste C, San Diego, CA 92115-6011 | 2019-09-28 |
| Find all providers in SAN DIEGO | ||||
| Street Address |
4130 MARYLAND ST |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92103-2330 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174140057 | Carmel Agdeppa | Acupuncturist | Chiropractique, 813 West Washington St., San Diego, CA 92103 | 2020-06-26 |
| 1568082717 | Salina Ann Bambic | Social Worker | 302 Washington Street Suite 420, San Diego, CA 92103 | 2020-04-17 |
| 1467099432 | Lina Hong | Behavior Technician | 3731 6th Ave. Suite 100, San Diego, Ca 92103, San Diego, CA 92103 | 2019-12-09 |
| 1154964567 | Rodger Stacy Questin, Psychologist P.C. | Psychologist | 440 Upas St Apt 402, San Diego, CA 92103 | 2019-10-18 |
| 1932740388 | Grace Tong-ventura | Pharmacist | 200 W. Arbor Drive, #8765, Suite 1-317, San Diego, CA 92103 | 2019-10-07 |
| 1306490453 | Genevieve Cheung | Pharmacist | 200 W Arbor Dr #8765, Department of Pharmacy, San Diego, CA 92103 | 2019-07-26 |
| 1801356837 | Marika Doviak | Acupuncturist | 2370 Hickory St, San Diego, CA 92103 | 2019-03-25 |
| 1982185070 | Tyler Lewis Roberts | Counselor | 4303 3rd Ave, San Diego, CA 92103 | 2018-08-27 |
| 1689151284 | Tori Breanne Blackwell | Occupational Therapist | 3731-a 6th Avenue, San Diego, CA 92103 | 2018-07-26 |
| 1952892614 | Pacific Bay Recovery Inc | Substance Abuse Rehabilitation Facility | 4095 Jackdaw St, San Diego, CA 92103 | 2018-05-29 |
| Find all providers in zip 92103 | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.