Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RI0200X | Infectious Disease | G59633 | CA |
NPI | 1073561601 |
---|---|
Provider Name | Dr. William Ritchie Mackenzie |
First Address | Los Angeles, CA 90045-5800 |
Second Address | Mather, CA 95655-4200 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/05/2006 |
Last Update Date | 08/07/2007 |