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General NPI Number Information
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NPI Number | 1013990563
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Entity Type | Individual
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Provider Name | TICH-HAO MACH MD
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Gender | Male
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Dates
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Enumeration Date | 11/29/2005
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Last Update Date | 05/15/2019
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Provider Practice Location Address
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Address Line | 6114 N 59TH AVE STE 4
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City | GLENDALE
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State | AZ
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Zip | 85301-7769
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Country | US
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Telephone | 623-937-8643
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Fax |
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Provider Business Mailing Address
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Address Line | 6114 N 59TH AVE STE 4
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City | GLENDALE
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State | AZ
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Zip | 85301-7769
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Country | US
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Telephone | 623-937-8643
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Fax | 623-934-1249
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 16640
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 16640
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License Number State | AZ
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