Individual provider Active NPI

Albert C Mak, M.D.

  • Specialist
  • Alhambra, CA
National Provider Identifier
1902910904
Registry record updated Mar 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
G79330 Issued in CA
Practice address
707 S Garfield Ave Ste B002
Alhambra, CA 91801-5866
Phone
(626) 227-2777
Fax
(626) 227-2747
NPI assigned
Aug 18, 2006
Last updated
Mar 24, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X G79330 CA Primary

Addresses

Primary practice location

707 S Garfield Ave Ste B002
Alhambra, CA 91801-5866

Mailing address

PO Box 80520
San Marino, CA 91118-8520
Phone (626) 227-2777

Other identifiers 1

IdentifierTypeStateIssuer
00G793300MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051019000704 CA Practitioner - Radiation Oncology 1759324684 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Radiation Oncology
Education
R Franklin University of Med & Sci/Chicago Medical School, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Albert C Mak MD IncGroup PAC ID 7113960048, 2 clinicians

Practice addresses (Care Compare)

707 S Garfield Ave
Suite B002
Alhambra, CA 91801-5866
Phone (626) 227-2777

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G79330CAMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Albert C Mak MD Inc CurrentSince Oct 22, 2001 Accepting new patients
R P Chao Radiology Medical Group Inc Past Accepting new patients
Pacific Medical Imaging and Oncology Center, Inc PastSince Oct 1, 2005 Accepting new patients

Locations

707 S Garfield Ave
Ste B002
Alhambra, CA 91801
Phone (626) 227-2777

381 Merrill Ave
Glendale, CA 91206
Phone (818) 409-8198

630 S Raymond Ave
Unit 104
Pasadena, CA 91105
Phone (626) 768-1021

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1155859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585008000000",
    "number": "1902910904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 80520",
            "city": "SAN MARINO",
            "state": "CA",
            "postal_code": "911188520",
            "telephone_number": "626-227-2777",
            "fax_number": "626-227-2747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 S GARFIELD AVE STE B002",
            "city": "ALHAMBRA",
            "state": "CA",
            "postal_code": "918015866",
            "telephone_number": "626-227-2777",
            "fax_number": "626-227-2747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAK",
        "first_name": "ALBERT",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-18",
        "last_updated": "2020-03-24",
        "certification_date": "2020-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "G79330",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G793300",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Alhambra, CA

Sources for this page

Verify at the official NPI Registry.