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NPI Code Detail

MEDICARE: ROBERT DS MACKAY M.D.

MEDICARE: ROBERT DS MACKAY M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12084P0800XPsychiatry PhysicianA43479CA

General Provider Information

NPI Number : 1083770630
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROBERT DS MACKAY M.D.
Provider Business Mailing Address
First Line : 1749 MARTIN LUTHER KING JR WAY
Second Line :
City : BERKELEY
State : CA
Zip : 94709-2139
Country : US
Telephone Number : 510-540-1749
Fax Number : 510-540-1707
Provider Business Practice Location Address
First Line : 1749 MARTIN LUTHER KING JR WAY
Second Line :
City : BERKELEY
State : CA
Zip : 94709-2139
Country : US
Telephone Number : 510-540-1749
Fax Number : 510-540-1707
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/28/2006
Last Update Date : 07/08/2007

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