Michael Melvin Kaback, MD

Primary specialty

Clinical Biochemical Genetics PhysicianTaxonomy code 207SG0202X

License

G23170 Issued in CA

Practice address

4347 Vista de la Tierra
Del Mar, CA 92014-4106

Phone

(858) 259-6801

NPI assigned

Jul 6, 2009

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1246838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1246838400000",
    "number": "1720217292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4347 VISTA DE LA TIERRA",
            "city": "DEL MAR",
            "state": "CA",
            "postal_code": "920144106",
            "telephone_number": "858-259-6801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4347 VISTA DE LA TIERRA",
            "city": "DEL MAR",
            "state": "CA",
            "postal_code": "920144106",
            "telephone_number": "858-259-6801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KABACK",
        "first_name": "MICHAEL",
        "middle_name": "MELVIN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-07-06",
        "last_updated": "2009-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207SG0202X",
            "taxonomy_group": "",
            "desc": "Medical Genetics, Clinical Biochemical Genetics",
            "state": "CA",
            "license": "G23170",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Biochemical Genetics Physician in Del Mar, CA
• Providers in Del Mar, CA by specialty
• Clinical Biochemical Genetics Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.