Provider Demographics
NPI:1700866340
Name:MACLAY, TRACY ANNE (MD)
Entity Type:Individual
Prefix:DR
First Name:TRACY
Middle Name:ANNE
Last Name:MACLAY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:TRACY
Other - Middle Name:ANNE
Other - Last Name:MACLAY-INKELES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:2025 SOQUEL AVE
Mailing Address - Street 2:
Mailing Address - City:SANTA CRUZ
Mailing Address - State:CA
Mailing Address - Zip Code:95060
Mailing Address - Country:US
Mailing Address - Phone:831-458-6300
Mailing Address - Fax:831-458-6305
Practice Address - Street 1:1203 MISSION STREET
Practice Address - Street 2:
Practice Address - City:SANTA CRUZ
Practice Address - State:CA
Practice Address - Zip Code:95060
Practice Address - Country:US
Practice Address - Phone:831-458-6300
Practice Address - Fax:831-421-8149
Is Sole Proprietor?:No
Enumeration Date:2006-01-19
Last Update Date:2019-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA74809207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine