Provider Demographics
NPI:1760431274
Name:HACK, TERRENCE C (MD, FACC)
Entity Type:Individual
Prefix:DR
First Name:TERRENCE
Middle Name:C
Last Name:HACK
Suffix:
Gender:M
Credentials:MD, FACC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:950 CIRCLE DR
Mailing Address - Street 2:
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93905-2150
Mailing Address - Country:US
Mailing Address - Phone:831-757-6237
Mailing Address - Fax:831-757-8458
Practice Address - Street 1:950 CIRCLE DR
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93905-2150
Practice Address - Country:US
Practice Address - Phone:831-757-6237
Practice Address - Fax:831-757-8458
Is Sole Proprietor?:No
Enumeration Date:2006-05-10
Last Update Date:2018-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA47871207R00000X
CAG50146207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA060001920OtherRAIL ROAD MEDICARE
MA2093928Medicaid
B73870Medicare UPIN
MAE05904Medicare PIN
MACXON38Medicare PIN