DR. MACK ROACH III (NPI# 1770523359) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770523359 |
| Entity Type | Individual |
| Full Name | DR. MACK ROACH III |
| Credential | M.D. |
| Practice Address |
1600 Divisadero Street H1031 San Francisco CA 94143-0001 |
| Mailing Address |
1600 Divisadero Street H1031 San Francisco CA 94143-1708 |
| Practice Telephone | 4153537175 |
| Practice Fax Number | 4153539883 |
| Mailing Telephone | 4153537175 |
| Mailing Fax Number | 4153539883 |
| Enumeration Date | 2006-06-08 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0203X |
Radiology Specialization: Therapeutic Radiology |
00G42845 | CA | Allopathic & Osteopathic Physicians |
| Street Address |
1600 DIVISADERO STREET H1031 |
| City | SAN FRANCISCO |
| State | CA |
| Zip Code | 94143-0001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487618831 | Alan P. Venook | Internal Medicine | 1600 Divisadero Street, San Francisco, CA 94143-0001 | 2006-04-13 |
| 1508220807 | Adrienne Miller Wakeling | Genetic Counselor, MS | 1600 Divisadero Street, 3rd Floor, San Francisco, CA 94143-3010 | 2016-04-12 |
| 1841441730 | Bridget Hogue | Nurse Practitioner | 1600 Divisadero Street, 2nd Floor Ucsf Carol Franc Buck Breast Care Center, San Francisco, CA 94115-0001 | 2008-10-09 |
| 1316108509 | Hyunseok Kang | Internal Medicine | 1600 Divisadero Street, San Francisco, CA 94115 | 2008-06-19 |
| 1821295833 | Sue Sun Yom | Radiology | 1600 Divisadero Street, H1031, San Francisco, CA 94143-1708 | 2007-07-02 |
| 1326134859 | Marc A. Dall'era | Urology | 1600 Divisadero Street, San Francisco, CA 94143-1695 | 2006-10-04 |
| 1548228653 | Brian S. Schwartz | Internal Medicine | 1600 Divisadero Street, San Francisco, CA 94143-0001 | 2006-05-01 |
| 1306803812 | Michelle Elizabeth Melisko | Internal Medicine | 1600 Divisadero Street, San Francisco, CA 94143-0001 | 2006-04-27 |
| 1215994827 | Gordon L Fung | Internal Medicine | 1600 Divisadero Street, Suite C-244 #1609, San Francisco, CA 94143-1609 | 2006-04-27 |
| 1053377424 | Frederic M Waldman | Pathology | 1600 Divisadero Street, San Francisco, CA 94143-0001 | 2006-04-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750909024 | Ana Chow | Social Worker | Ucsf - Benioff Children's Hospital, 1975 4th St, San Francisco, CA 94143 | 2020-07-13 |
| 1801413828 | Caroline Eilbeck Casey | Social Worker | 1975 4th Street, San Francisco, CA 94143 | 2020-06-26 |
| 1124642251 | Grace Kibuule | Student in an Organized Health Care Education/Training Program | 513 Parnassus Ave., S455, San Francisco, CA 94143 | 2020-06-04 |
| 1003436528 | Christian Karl Antonio | Nurse Practitioner | 505 Parnassus Avennue, San Francisco, CA 94143 | 2020-04-24 |
| 1144859752 | Reginald Nguyen | Student in an Organized Health Care Education/Training Program | 505 Parnassus Avenue, Room M24, San Francisco, CA 94143 | 2020-04-06 |
| 1851929830 | Jonathan Earl Freise | Student in an Organized Health Care Education/Training Program | Ucsf Department of Surgery, 513 Parnassus Ave, S321, San Francisco, CA 94143 | 2020-03-27 |
| 1275160046 | Sang Minh Nguyen | Student in an Organized Health Care Education/Training Program | 550-16th Street, Mission Hall, 4th Floor, San Francisco, CA 94143 | 2020-03-23 |
| 1780239954 | Rishabh Pravin Acharya | Dentist | 707 Parnassus Avenue, D-4000, San Francisco, CA 94143 | 2019-08-05 |
| 1306307442 | Kayla Zamora | Student in an Organized Health Care Education/Training Program | 550-16th Street, Mission Hall 4th Floor, San Francisco, CA 94143 | 2019-03-30 |
| 1730649021 | Elizabeth Larken Burch | Student in an Organized Health Care Education/Training Program | Univerisity of California San Francisco 550 16th Street, Mission Hall 4th Floor, San Francisco, CA 94143 | 2019-03-22 |
| Find all providers in zip 94143 | ||||
| Taxonomy Code | 2085R0203X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Therapeutic Radiology |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124062351 | Richard M. Krieg | Radiology | 1600 Divisadero St, San Francisco, CA 94115-3010 | 2006-06-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831692243 | Joseph Vernon Hodgkins | Radiology | 5901 E 7th St Bldg 165, Long Beach, CA 90822-5201 | 2018-03-12 |
| 1225296676 | Dwight Raymond Stickney | Radiology | 5275 Ashby Ln, Granite Bay, CA 95746-9425 | 2008-06-01 |
| 1487811824 | Brian D. Berger, Md, Pa | Radiology | 1341 David St, #111, San Mateo, CA 94403-1916 | 2008-05-22 |
| 1174664890 | John Charles Clark | Radiology | 1325 Bambury Ct, Redding, CA 96001-1339 | 2007-02-08 |
| 1598837569 | Clayton Chen | Radiology | 60mdg/sgqx, 101 Bodin Circle, Travis Afb, CA 94535-1800 | 2006-11-15 |
| 1861587727 | Steve Byron Benak Jr. | Radiology | 7024 N. Park Ridge Court, Riverbank, CA 95367 | 2006-10-04 |
| 1609842392 | Harvey S Frey | Radiology | 552 12th St, Santa Monica, CA 90402-2908 | 2006-02-23 |
| 1356322705 | Florian H Ploch | Radiology | 1020 Nut Tree Rd, #190, Vacaville, CA 95687-4100 | 2005-11-10 |
| 1922091263 | Victor G Schweitzer | Radiology | 2985 Sycamore Dr, Simi Valley, CA 93065-1201 | 2005-08-23 |
| 1528460334 | Reinhard Wilhelm Schulte | Radiology | 9834 Genesee Ave, Suite 110, La Jolla, CA 92037-1223 | 2014-09-23 |
| Find all providers with the same taxonomy | ||||
| City | SAN FRANCISCO |
| Zip Code | 94143 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.