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Mr. Eddie Sidney Mack SR.
Student in an Organized Health Care Education/Training Program in Pico Rivera, California
NPI 1184059420

Eddie Sidney Mack SR. is a Student in an Organized Health Care Education/Training Program based in Pico Rivera, CA. Eddie Sidney Mack SR. practices in Pico Rivera, CA. The NPI Number for Eddie Sidney Mack SR. is 1184059420 and holds a License No. (California).

The current practice location address for Eddie Sidney Mack SR. is 9101 Whittier Blvd, Pico Rivera, CA and can be reached out via phone at 562-801-4626.

Location: 9101 Whittier Blvd, Pico Rivera, CA, 90660-2405
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1184059420
Provider Name
Eddie Sidney Mack SR.
Credential
Provider Entity Type
Individual
Gender
Male
Address
9101 Whittier Blvd, Pico Rivera, CA, 90660-2405
Phone Number
562-801-4626
Fax Number
Provider Enumeration Date
09/05/2013
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
9101 Whittier Blvd
City
Pico Rivera
State
California
Zip
90660-2405
Phone Number
562-801-4626
Fax Number
person
Provider Business Mailing Address Details
Address
9101 Whittier Blvd
City
Pico Rivera
State
California
Zip
90660-2405
Phone Number
562-801-4626
Fax Number
person
Provider's Taxonomy Details 1
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
()
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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