Nelly K. Mac, M.D., Inc.

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

A32817 Issued in CA

Legal business name

NELLY K. MAC, M.D., INC.

Practice address

3400 Loma Vista Rd
Ste. 9
Ventura, CA 93003-3033

Phone

(805) 644-4477

NPI assigned

Jul 15, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Nelly K. Mac, M.D.NPI 1073546750

Title

President

Phone

(310) 440-3131

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Nelly K Mac, M.D.

  • Anesthesiology Physician
  • Ventura, CA
  • NPI 1073546750
  NPD (past) Authorized official

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

{
    "created_epoch": "1152921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1851317275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11999 SAN VICENTE BLVD",
            "address_2": "STE. 440",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900495131",
            "telephone_number": "310-440-3131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 LOMA VISTA RD",
            "address_2": "STE. 9",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930033033",
            "telephone_number": "805-644-4477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NELLY K. MAC, M.D., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-15",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MAC",
        "authorized_official_first_name": "NELLY",
        "authorized_official_middle_name": "K.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "310-440-3131",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "A32817",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melissa Navarro
• Robert C Navarro
• Samuel Navarro
• Paulita H Neal, PHD
• Michael Allen Neasham, PHARM.D.
• Nadine Nelson Manning, AMFT
• Stace Lee Nelson-Hicks, L.AC.
• Andrew Paul Nelson, LMFT
• Leann Angelina Nelson
• Lucas Nelson, LCSW

• Anesthesiology Physician in Ventura, CA
• Providers in Ventura, CA by specialty
• Anesthesiology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.