Provider Demographics
NPI:1245986124
Name:MAC HOSPITAL
Entity type:Organization
Organization Name:MAC HOSPITAL
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:ISAAC
Authorized Official - Middle Name:
Authorized Official - Last Name:SIMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:440-548-0905
Mailing Address - Street 1:1037 NE 65TH ST # 81324
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98115-6655
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:MAC HOSPITAL
Practice Address - Street 2:CAM. A ALCOCER 12, SALTITO DE GUADALUPE
Practice Address - City:SAN MIGUEL DE ALLENDE
Practice Address - State:MEXICO
Practice Address - Zip Code:37745
Practice Address - Country:MX
Practice Address - Phone:888-449-7799
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-01
Last Update Date:2024-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes282N00000XHospitalsGeneral Acute Care HospitalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CHO081174Z5OtherSTATE