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General NPI Number Information
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NPI Number | 1568595239
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Entity Type | Organization
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Legal Business Name | BENJAMIN H. MAECK, III, M.D. INC.
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Dates
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Enumeration Date | 03/13/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2250 HAYES ST SUITE 205
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City | SAN FRANCISCO
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State | CA
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Zip | 94117-1078
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Country | US
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Telephone | 415-750-5730
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Fax | 415-750-4973
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Provider Business Mailing Address
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Address Line | 2250 HAYES ST SUITE 205
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City | SAN FRANCISCO
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State | CA
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Zip | 94117-1078
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Country | US
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Telephone | 415-750-5730
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Fax | 415-750-4973
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Authorized Official
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Title or Position | PHYSICIAN OWNER
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Name | DR. BENJAMIN H MAECK III
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Credential | M.D.
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Telephone | 415-750-5730
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | A71812
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License Number State | CA
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