Healthcare Provider Details

I. General information

NPI: 1730297805
Provider Name (Legal Business Name): MAC LINCOLN STERLING M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/28/2006
Last Update Date: 02/23/2021
Certification Date: 02/23/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2450 ASHBY AVE RM 5505
BERKELEY CA
94705-2067
US

IV. Provider business mailing address

325 DISTEL CIR
LOS ALTOS CA
94022-1408
US

V. Phone/Fax

Practice location:
  • Phone: 510-204-4444
  • Fax: 510-649-8287
Mailing address:
  • Phone: 510-204-1893
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberA60023
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: