Dr. Mack, LLC

Primary specialty

Emergency Care Clinic/CenterTaxonomy code 261QE0002X

Legal business name

DR. MACK, LLC

Doing business as

Gynecology Emergent Care Center

Practice address

3711 Long Beach Blvd
Suite 101 B
Long Beach, CA 90807-3315

Phone

(855) 376-2496

NPI assigned

Aug 21, 2013

Last updated

Aug 21, 2013By 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

Miriam Mackovic, MD

Title

Owner

Phone

(855) 376-2496

Specialties & licenses 1

Addresses

Other names 1

• Gynecology Emergent Care Center Doing business as

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

{
    "created_epoch": "1377043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1377043200000",
    "number": "1902230394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3711 LONG BEACH BLVD",
            "address_2": "SUITE 101 B",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908073315",
            "telephone_number": "855-376-2496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3711 LONG BEACH BLVD",
            "address_2": "SUITE 101 B",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908073315",
            "telephone_number": "855-376-2496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. MACK, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-21",
        "last_updated": "2013-08-21",
        "status": "A",
        "authorized_official_last_name": "MACKOVIC",
        "authorized_official_first_name": "MIRIAM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "855-376-2496",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QE0002X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Emergency Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gynecology Emergent Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Emergency Care Clinic/Center in Long Beach, CA
• Providers in Long Beach, CA by specialty
• Emergency Care Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2013; 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.