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General NPI Number Information
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NPI Number | 1821070202
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Entity Type | Individual
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Provider Name | DAVID MACH D.O.
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Gender | Male
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Dates
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Enumeration Date | 11/18/2005
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Last Update Date | 11/30/2007
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Provider Practice Location Address
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Address Line | 2261 DOUGLAS BLVD
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City | ROSEVILLE
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State | CA
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Zip | 95661-3831
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Country | US
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Telephone | 916-783-7193
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Fax | 916-783-0801
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Provider Business Mailing Address
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Address Line | 1798 DARBY ST
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City | ROSEVILLE
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State | CA
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Zip | 95747-4809
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Country | US
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Telephone | 916-772-2749
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Fax |
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 20A7898
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License Number State | CA
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