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General NPI Number Information
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NPI Number | 1861484511
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Entity Type | Individual
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Provider Name | JEFFREY G MACE MD
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Gender | Male
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Dates
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Enumeration Date | 08/18/2005
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Last Update Date | 01/10/2013
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Provider Practice Location Address
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Address Line | 242 GREEN VALLEY RD
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City | FREEDOM
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State | CA
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Zip | 95019-3137
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Country | US
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Telephone | 831-724-1811
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Fax | 831-724-1866
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Provider Business Mailing Address
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Address Line | 598 BROWNS VALLEY RD
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City | WATSONVILLE
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State | CA
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Zip | 95076-0334
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Country | US
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Telephone | 831-724-1811
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Fax | 831-724-1866
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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 | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | G32527
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License Number State | CA
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